Provider Demographics
NPI:1477114072
Name:FORYSINSKI, HANNAH (NP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:FORYSINSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 THORN AVE
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2600
Mailing Address - Country:US
Mailing Address - Phone:716-662-2040
Mailing Address - Fax:716-662-0019
Practice Address - Street 1:326 ORCHARD PARK RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2635
Practice Address - Country:US
Practice Address - Phone:716-828-0560
Practice Address - Fax:716-823-0751
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY770949-01163W00000X
NYF402715-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse