Provider Demographics
NPI:1033114574
Name:PASEK, ANN MARIE (NPP)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:PASEK
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:ANN MARIE
Other - Middle Name:
Other - Last Name:PASEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:11901 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14004-9454
Mailing Address - Country:US
Mailing Address - Phone:716-937-3300
Mailing Address - Fax:716-937-3304
Practice Address - Street 1:11901 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ALDEN
Practice Address - State:NY
Practice Address - Zip Code:14004-9454
Practice Address - Country:US
Practice Address - Phone:716-937-3300
Practice Address - Fax:716-937-3304
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400624363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000560709004OtherBCBS OF WNY
NY9590016OtherINDEPENDENT HEALTH
NYJ300000059OtherMEDICARE PTAN
NY000560709005OtherBCBS OF WNY
NY000560709005OtherBCBS OF WNY