Healthcare Provider Details

I. General information

NPI: 1295750958
Provider Name (Legal Business Name): DANIEL ZAYAC PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 GRIDER ST
BUFFALO NY
14215-3021
US

IV. Provider business mailing address

11281 PARTRIDGE RD
HOLLAND NY
14080-9621
US

V. Phone/Fax

Practice location:
  • Phone: 716-898-5111
  • Fax: 716-898-5324
Mailing address:
  • Phone: 716-898-5111
  • Fax: 716-898-5324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number003441-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: