Healthcare Provider Details

I. General information

NPI: 1033114574
Provider Name (Legal Business Name): ANN MARIE PASEK NPP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANN MARIE PASEK N.P.

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 12/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11901 BROADWAY ST
ALDEN NY
14004-9454
US

IV. Provider business mailing address

11901 BROADWAY ST
ALDEN NY
14004-9454
US

V. Phone/Fax

Practice location:
  • Phone: 716-937-3300
  • Fax: 716-937-3304
Mailing address:
  • Phone: 716-937-3300
  • Fax: 716-937-3304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400624
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: