Provider Demographics
NPI:1740970433
Name:OMECHINSKI, SUNNI
Entity type:Individual
Prefix:
First Name:SUNNI
Middle Name:
Last Name:OMECHINSKI
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 1:409 SPRIN AVE.
Mailing Address - Street 2:
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26852
Mailing Address - Country:US
Mailing Address - Phone:305-530-2256
Mailing Address - Fax:
Practice Address - Street 1:409 SPRIN AVE.
Practice Address - Street 2:
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26852
Practice Address - Country:US
Practice Address - Phone:305-530-2256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant