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Individual

MR. ZACHARY W MINER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
6000 BROCKTON DR, LOCKPORT, NY 14094-9273
(716) 845-3400
(716) 438-1430
Mailing address
3041 ORCHARD PARK RD, STE C, ORCHARD PARK, NY 14127-1238
(716) 674-3104
(716) 674-0666

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary
030004
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07680968
NY
Enumeration date
05/05/2023
Last updated
04/21/2025
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