Provider Demographics
NPI:1437528569
Name:MATUSZAK, WENDY MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:MARIE
Last Name:MATUSZAK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8155 ROSEVILLE LANE
Mailing Address - Street 2:
Mailing Address - City:E AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051
Mailing Address - Country:US
Mailing Address - Phone:716-380-0081
Mailing Address - Fax:716-580-3101
Practice Address - Street 1:8155 ROSEVILLE LN
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1931
Practice Address - Country:US
Practice Address - Phone:716-380-0081
Practice Address - Fax:716-580-3101
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY584232-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse