Provider Demographics
NPI:1023298387
Name:TRZEWIECZYNSKI, DEAN PAUL
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:PAUL
Last Name:TRZEWIECZYNSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 WALDEN AVE
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4751
Mailing Address - Country:US
Mailing Address - Phone:716-681-2968
Mailing Address - Fax:716-681-2270
Practice Address - Street 1:3050 UNION RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1215
Practice Address - Country:US
Practice Address - Phone:716-677-4360
Practice Address - Fax:716-677-6710
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist