Provider Demographics
NPI:1053499939
Name:ZYBCZYNSKI, DIANA LOUISE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:LOUISE
Last Name:ZYBCZYNSKI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:DIANA
Other - Middle Name:LOUISE
Other - Last Name:MUSZYNSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1628 BURROUGH RD
Mailing Address - Street 2:
Mailing Address - City:COWLESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14037-9716
Mailing Address - Country:US
Mailing Address - Phone:585-591-3703
Mailing Address - Fax:
Practice Address - Street 1:81 MAIN ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2101
Practice Address - Country:US
Practice Address - Phone:585-344-1570
Practice Address - Fax:585-344-2946
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36776183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist