National Provider Identifier
Michael J Pietrusik, DPM
Michael J Pietrusik, DPM is listed in the NPPES registry with a primary specialty of Podiatrist in Lackawanna, NY and a listed phone number of (716) 822-3411.
Profile Overview
- NPI
- 1356368864
- Provider Type
- Individual
- Primary Specialty
- Podiatrist
- Enumeration Date
- July 17, 2006
- Last Updated
- October 14, 2011
Practice Location
- 3277 South Park Avenue
- Lackawanna, NY 14218-3527
Phone: (716) 822-3411
Specialties
- Podiatrist (213E00000X)
Full Record
- NPI
- 1356368864
- Entity Type
- Individual
- Last Name
- Pietrusik
- First Name
- Michael
- Middle Name
- J
- Credential
- DPM
- Mailing Street Address
- 3277 South Park Avenue
- Mailing City
- Lackawanna
- Mailing State
- NY
- Mailing ZIP Code
- 14218-3527
- Mailing Country
- US
- Mailing Phone
- (716) 822-3411
- Mailing Fax
- (716) 822-0215
- Practice Street Address
- 3277 South Park Avenue
- Practice City
- Lackawanna
- Practice State
- NY
- Practice ZIP Code
- 14218-3527
- Practice Country
- US
- Practice Phone
- (716) 822-3411
- Practice Fax
- (716) 822-0215
- Enumeration Date
- July 17, 2006
- Last Updated
- October 14, 2011
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Podiatrist (213E00000X)
- Other Identifiers
- 00845978 (NY)