Individual
JILL KACZMAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
4711 TRANSIT RD, LANCASTER, NY 14043-4888
(716) 668-5331
(716) 668-5370
Mailing address
4711 TRANSIT RD, LANCASTER, NY 14043-4888
(716) 668-5331
(716) 668-5370
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F333250
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026518302
UNIVERA
NY
01
—
000560626003
BC/BS
NY
05
—
02343424
—
NY
01
—
9511960
IHA
NY
Enumeration date
12/29/2005
Last updated
07/21/2014
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