Provider Demographics
NPI:1215910880
Name:PIKO, AMY H (OD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:H
Last Name:PIKO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7707 94TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-1955
Mailing Address - Country:US
Mailing Address - Phone:262-597-1040
Mailing Address - Fax:262-597-1041
Practice Address - Street 1:7707 94TH AVE
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-1955
Practice Address - Country:US
Practice Address - Phone:262-597-1040
Practice Address - Fax:262-597-1041
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-009771152W00000X
WI3369-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist