MEDICARE: DR. MARK RICHARD ZAMBRON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	209551	NY
2	207R00000X	Internal Medicine Physician	209551	NY

General Provider Information

NPI Number	:	1669435103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK RICHARD ZAMBRON MD

Provider Business Mailing Address
First Line	:	206 S ELMWOOD AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14201-2398
Country	:	US
Telephone Number	:	716-847-2441
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 HERTEL AVE STE 100
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14207-1906
Country	:	US
Telephone Number	:	716-847-2441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	09/19/2025

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