Provider Demographics
NPI:1356365829
Name:PAWLOWSKI, LOUIS (NP)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:PAWLOWSKI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 BAILEY AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14212-2008
Mailing Address - Country:US
Mailing Address - Phone:716-893-8550
Mailing Address - Fax:716-893-4020
Practice Address - Street 1:1595 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14212-2008
Practice Address - Country:US
Practice Address - Phone:716-893-8550
Practice Address - Fax:716-893-4020
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303984163WP0000X
NY0224404363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP0000XNursing Service ProvidersRegistered NursePain Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02578072Medicaid
H65968Medicare UPIN