Healthcare Provider Details

I. General information

NPI: 1023298387
Provider Name (Legal Business Name): MR. DEAN PAUL TRZEWIECZYNSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 10/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 UNION RD
ORCHARD PARK NY
14127-1215
US

IV. Provider business mailing address

2470 WALDEN AVE SUITE 2400
CHEEKTOWAGA NY
14225-4751
US

V. Phone/Fax

Practice location:
  • Phone: 716-677-4360
  • Fax: 716-677-6710
Mailing address:
  • Phone: 716-681-2968
  • Fax: 716-681-2270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number046081
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: