Provider Demographics
NPI:1528946811
Name:MOLLY A PIEKUT LLC
Entity type:Organization
Organization Name:MOLLY A PIEKUT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIEKUT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, BCN
Authorized Official - Phone:516-885-2336
Mailing Address - Street 1:253 FOXCROFT DR E
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-5612
Mailing Address - Country:US
Mailing Address - Phone:516-885-2336
Mailing Address - Fax:
Practice Address - Street 1:253 FOXCROFT DR E
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-5612
Practice Address - Country:US
Practice Address - Phone:516-885-2336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health