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General NPI Number Information
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NPI Number | 1942654652
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Entity Type | Individual
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Provider Name | CASSIAN MICHAEL HOROSZCZAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 3435 MAIN STREET 252 FARBER HALL
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City | BUFFALO
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State | NY
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Zip | 14214-8001
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Country | US
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Telephone | 716-829-6102
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Fax | 716-829-3640
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 042.0018579
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License Number State | VT
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