Individual ProviderAgnieszka LantowskiPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address256 Mason Ave, Bldg C, 3rd Floor, Staten Island, NY 10305-3408(718) 226-6780(917) 604-8657PECOS EnrollmentBased on the most recent information from CMS, provider Agnieszka Lantowski is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1457527566Provider TypeIndividualFull NameLantowski, AgnieszkaCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date5/8/2008Last Updated8/8/2013Contact InformationPractice LocationPractice Address256 Mason Ave, Bldg C, 3rd Floor, Staten Island, NY 10305-3408Phone(718) 226-6780FaxUnlisted FaxMailing LocationMailing Address470 Gower St, Staten Island, NY 10314-6461Phone(917) 604-8657FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense011314New YorkProvider IdentifiersIDDescriptionIssuerID03596229DescriptionMedicaidIssuerUnlistedNew York