Provider Demographics
NPI:1124502828
Name:NOWINSKI, CRISTIE MARIE (LMT)
Entity type:Individual
Prefix:
First Name:CRISTIE
Middle Name:MARIE
Last Name:NOWINSKI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2437 BERG RD STE E
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14218-3785
Mailing Address - Country:US
Mailing Address - Phone:716-440-4898
Mailing Address - Fax:
Practice Address - Street 1:2437 BERG RD STE E
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14218-3785
Practice Address - Country:US
Practice Address - Phone:716-440-4898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027653-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist