Provider Demographics
NPI:1679581862
Name:ZAKRZEWSKI, SUSAN M (NP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:ZAKRZEWSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-857-8666
Mailing Address - Fax:716-630-1054
Practice Address - Street 1:295 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8216
Practice Address - Country:US
Practice Address - Phone:716-630-1000
Practice Address - Fax:716-630-1254
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333718-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02513702Medicaid
NY00026797401OtherUNIVERA
NY161000580OtherNOVA
NY000560852002OtherHEALTH NOW
NY9512526OtherIHA
NYP00176317OtherRR MEDICARE
NY00026797401OtherUNIVERA
NY9512526OtherIHA