Provider Demographics
NPI:1922436559
Name:ANDRZEJEWSKI, RENEE LYNN (ANP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:LYNN
Last Name:ANDRZEJEWSKI
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:LYNN
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 ESSJAY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8235
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-4223
Practice Address - Fax:716-859-4222
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306672363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health