Healthcare Provider Details
I. General information
NPI: 1659337152
Provider Name (Legal Business Name): HAMBURG REGIONAL GYNECOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2006
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
240 RED TAIL RD STE 2
ORCHARD PARK NY
14127-1582
US
IV. Provider business mailing address
240 RED TAIL RD STE 2
ORCHARD PARK NY
14127-1582
US
V. Phone/Fax
- Phone: 716-649-6500
- Fax: 716-649-0031
- Phone: 716-649-6500
- Fax: 716-649-0031
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SCOTT
JEFFREY
ZUCCALA
Title or Position: OWNER
Credential: DO
Phone: 716-649-6500