Provider Demographics
NPI:1083900054
Name:ZYNDA, MARCELLA (NP)
Entity Type:Individual
Prefix:MS
First Name:MARCELLA
Middle Name:
Last Name:ZYNDA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 ABBOTT RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-1700
Mailing Address - Country:US
Mailing Address - Phone:716-828-3724
Mailing Address - Fax:716-828-3461
Practice Address - Street 1:515 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-1700
Practice Address - Country:US
Practice Address - Phone:716-828-3724
Practice Address - Fax:716-828-3461
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30305712364SA2200X
NY305712363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health