Provider Demographics
NPI:1720071780
Name:PIECZONKA, SHEILA (DO)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:
Last Name:PIECZONKA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 ORCHARD PARK ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224
Mailing Address - Country:US
Mailing Address - Phone:716-675-5222
Mailing Address - Fax:716-675-9329
Practice Address - Street 1:3050 ORCHARD PARK ROAD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224
Practice Address - Country:US
Practice Address - Phone:716-675-5222
Practice Address - Fax:716-675-9329
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2238251207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0225Medicaid
CC8815Medicare ID - Type Unspecified
H60215Medicare UPIN