Healthcare Provider Details

I. General information

NPI: 1285864900
Provider Name (Legal Business Name): ALYSSA ZOLNOWSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 MARYVALE DR.
CHEEKTOWAGA NY
14225
US

IV. Provider business mailing address

823 MARYVALE DR.
CHEEKTOWAGA NY
14225
US

V. Phone/Fax

Practice location:
  • Phone: 716-903-5799
  • Fax:
Mailing address:
  • Phone: 716-903-5799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number539008-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: