Provider Demographics
NPI:1013966647
Name:CHRZANOWSKI, STEPHEN GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GERARD
Last Name:CHRZANOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224
Mailing Address - Country:US
Mailing Address - Phone:716-675-0707
Mailing Address - Fax:716-674-1836
Practice Address - Street 1:290 CENTER RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224
Practice Address - Country:US
Practice Address - Phone:716-675-0707
Practice Address - Fax:716-674-1836
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2100441207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0410546OtherIHA
00010367304OtherUNIVERA
000525367004OtherBCBS
0410546OtherIHA
BB5962Medicare ID - Type Unspecified