Healthcare Provider Details

I. General information

NPI: 1235492331
Provider Name (Legal Business Name): EMILY A SARZYNIAK RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2012
Last Update Date: 10/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 PARK CLUB LN SUITE 100
WILLIAMSVILLE NY
14221-5263
US

IV. Provider business mailing address

40 GEORGE KARL BLVD
WILLIAMSVILLE NY
14221-7183
US

V. Phone/Fax

Practice location:
  • Phone: 716-839-9402
  • Fax: 716-839-3570
Mailing address:
  • Phone: 716-218-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number015654
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number015654
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: