Healthcare Provider Details

I. General information

NPI: 1417485871
Provider Name (Legal Business Name): JONATHAN COLLIN ZIRNA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 05/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 BAILEY AVE
BUFFALO NY
14215-1145
US

IV. Provider business mailing address

8581 LAKEMONT DR
EAST AMHERST NY
14051-2073
US

V. Phone/Fax

Practice location:
  • Phone: 716-835-2966
  • Fax:
Mailing address:
  • Phone: 716-906-9005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: