Provider Demographics
NPI:1578120580
Name:CZMOREK, BRITTANY NICOLE (MB, BCH, BAO)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICOLE
Last Name:CZMOREK
Suffix:
Gender:F
Credentials:MB, BCH, BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 GOODELL STREET
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203
Mailing Address - Country:US
Mailing Address - Phone:716-816-7258
Mailing Address - Fax:716-845-6699
Practice Address - Street 1:77 GOODELL STREET
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203
Practice Address - Country:US
Practice Address - Phone:716-816-7258
Practice Address - Fax:716-845-6699
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2020-01-27
Deactivation Date:2020-01-13
Deactivation Code:
Reactivation Date:2020-01-27
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program