Provider Demographics
NPI:1093862369
Name:NORBERT J SZYMULA MD PC
Entity Type:Organization
Organization Name:NORBERT J SZYMULA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NORBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SZYMULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-433-1121
Mailing Address - Street 1:115 PROFESSIONAL PKWY
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-5369
Mailing Address - Country:US
Mailing Address - Phone:716-433-1121
Mailing Address - Fax:716-433-5425
Practice Address - Street 1:115 PROFESSIONAL PKWY
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-5369
Practice Address - Country:US
Practice Address - Phone:716-433-1121
Practice Address - Fax:716-433-5425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124226207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000508003001OtherBLUE CROSSBLUE SHIELD WNY
NY00010176701OtherUNIVERA PROVIDER
NY1005373OtherINDEPENT HEALTH PROVIDER
NY00611445Medicaid
NYCOL 124226-2OtherWORKER COMPENSATION
NYB36115Medicare UPIN
NYCOL 124226-2OtherWORKER COMPENSATION