Healthcare Provider Details

I. General information

NPI: 1508059296
Provider Name (Legal Business Name): KATHERINE ANNE ZUKOTYNSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2007
Last Update Date: 10/18/2025
Certification Date: 10/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST DEPARTMENT OF RADIOLOGY
BOSTON MA
02115-6110
US

IV. Provider business mailing address

ELM AND CARLTON ST
BUFFALO NY
14263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-4004
  • Fax:
Mailing address:
  • Phone: 716-845-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number231153
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: