Provider Demographics
NPI:1417485871
Name:ZIRNA, JONATHAN COLLIN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:COLLIN
Last Name:ZIRNA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8581 LAKEMONT DR
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-2073
Mailing Address - Country:US
Mailing Address - Phone:716-906-9005
Mailing Address - Fax:
Practice Address - Street 1:3435 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1145
Practice Address - Country:US
Practice Address - Phone:716-835-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical