Provider Demographics
NPI:1659916062
Name:WOZNIAK, ALYSSA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:WOZNIAK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:MARIE
Other - Last Name:CIZDZIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:12595 MORTONS CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14141-9788
Mailing Address - Country:US
Mailing Address - Phone:716-860-3998
Mailing Address - Fax:
Practice Address - Street 1:320 PORTER AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1032
Practice Address - Country:US
Practice Address - Phone:716-829-8440
Practice Address - Fax:716-829-7904
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist