Provider Demographics
NPI:1649780644
Name:PIENKOWSKI, JAMES CHESTER (PARAMEDIC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHESTER
Last Name:PIENKOWSKI
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 GLENCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-2303
Mailing Address - Country:US
Mailing Address - Phone:315-415-5696
Mailing Address - Fax:
Practice Address - Street 1:4655 GLENCLIFFE RD
Practice Address - Street 2:
Practice Address - City:MANLIUS
Practice Address - State:NY
Practice Address - Zip Code:13104-2303
Practice Address - Country:US
Practice Address - Phone:315-415-5696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237817146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic