Provider Demographics
NPI:1417011859
Name:STYBORSKI, WILLIAM A (NP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:STYBORSKI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2237
Mailing Address - Country:US
Mailing Address - Phone:716-366-7150
Mailing Address - Fax:716-366-3566
Practice Address - Street 1:322 PARK AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2237
Practice Address - Country:US
Practice Address - Phone:716-366-7150
Practice Address - Fax:716-366-3566
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333063363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF333063OtherNYS LICENSE
NYMS1183677OtherDEA