Healthcare Provider Details

I. General information

NPI: 1013974070
Provider Name (Legal Business Name): KATHLEEN ANN ZIOMEK N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 BRYANT ST UNIVERSITY INTERNAL MEDICINE AND PEDIATRICS
BUFFALO NY
14222-2006
US

IV. Provider business mailing address

4979 HARLEM RD
AMHERST NY
14226-2547
US

V. Phone/Fax

Practice location:
  • Phone: 716-878-7655
  • Fax: 716-878-1155
Mailing address:
  • Phone: 716-923-4380
  • Fax: 716-923-4384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number332483
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: