Basic Information
| Provider Information | |||||||||
| NPI: | 1184665382 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLEJNICZAK | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | JOHN | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4185 SENECA STREET | ||||||||
| Address2: | SUITE 11 | ||||||||
| City: | WEST SENECA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166748189 | ||||||||
| FaxNumber: | 7167120469 | ||||||||
| Practice Location | |||||||||
| Address1: | 529 CENTRAL AVE | ||||||||
| Address2: | BROOKS MEMORIAL HOSPITAL | ||||||||
| City: | DUNKIRK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163661111 | ||||||||
| FaxNumber: | 7163637288 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 3311011 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.