Provider Demographics
NPI:1174017594
Name:MAZUREK, ALLISON (PA-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MAZUREK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:PIERI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:705 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3291
Mailing Address - Country:US
Mailing Address - Phone:716-839-0632
Mailing Address - Fax:716-839-2012
Practice Address - Street 1:705 MAPLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3291
Practice Address - Country:US
Practice Address - Phone:716-839-0632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022259363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical