Healthcare Provider Details

I. General information

NPI: 1871954412
Provider Name (Legal Business Name): SOLOMIA ZHOWNIROVYCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2016
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 PIERCE RD
CLIFTON PARK NY
12065
US

IV. Provider business mailing address

362 S MAIN ST
ALBION NY
14411-1603
US

V. Phone/Fax

Practice location:
  • Phone: 518-373-1181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number059132-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: