Individual
MARK R KUCZMANSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
325 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-8243
(716) 631-2517
Mailing address
425 ESSJAY RD, STE 170, WILLIAMSVILLE, NY 14221-5782
(716) 630-1219
(716) 817-1726
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
011966
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00028138901
UNIVERA
NY
01
—
000529486001
HEALTH NOW
NY
05
—
02908845
—
NY
01
—
9514276
INDEPENDENT HEALTH
NY
Enumeration date
08/14/2007
Last updated
12/20/2021
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