Healthcare Provider Details

I. General information

NPI: 1679581862
Provider Name (Legal Business Name): SUSAN M ZAKRZEWSKI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 04/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 ESSJAY RD
WILLIAMSVILLE NY
14221-8216
US

IV. Provider business mailing address

6255 SHERIDAN DR SUITE 304
WILLIAMSVILLE NY
14221-4836
US

V. Phone/Fax

Practice location:
  • Phone: 716-630-1000
  • Fax: 716-630-1254
Mailing address:
  • Phone: 716-857-8666
  • Fax: 716-630-1054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF333718-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: