Provider Demographics
NPI:1023779410
Name:PIENTA, MOLLY CAROLINE
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:CAROLINE
Last Name:PIENTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 HARBOR RUN LN
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:NY
Mailing Address - Zip Code:14085-9674
Mailing Address - Country:US
Mailing Address - Phone:716-725-9003
Mailing Address - Fax:
Practice Address - Street 1:2206 HARBOR RUN LN
Practice Address - Street 2:
Practice Address - City:LAKE VIEW
Practice Address - State:NY
Practice Address - Zip Code:14085-9674
Practice Address - Country:US
Practice Address - Phone:716-725-9003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY834353163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse