Healthcare Provider Details

I. General information

NPI: 1982053302
Provider Name (Legal Business Name): CAROL ANNE ZOMBEK-DIBELLA RN, CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 04/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 10TH ST
NIAGARA FALLS NY
14301-1813
US

IV. Provider business mailing address

621 10TH ST
NIAGARA FALLS NY
14301-1813
US

V. Phone/Fax

Practice location:
  • Phone: 716-278-4000
  • Fax: 716-278-4663
Mailing address:
  • Phone: 716-278-4000
  • Fax: 716-278-4663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number291039
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: