Healthcare Provider Details

I. General information

NPI: 1972515740
Provider Name (Legal Business Name): THADDEUS E SZARZANOWICZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 PARK CLUB LANE SUITE 100
WILLIAMSVILLE NY
14221-5328
US

IV. Provider business mailing address

192 PARK CLUB LANE SUITE 100
WILLIAMSVILLE NY
14221
US

V. Phone/Fax

Practice location:
  • Phone: 716-204-1101
  • Fax: 716-204-0914
Mailing address:
  • Phone: 716-204-1101
  • Fax: 716-204-0914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number200802
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: