Provider Demographics
NPI:1184401655
Name:CREATIVE RESTORATIONS, INC
Entity type:Organization
Organization Name:CREATIVE RESTORATIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PRESIDENT/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HARZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CASAC-T/CRPA-P
Authorized Official - Phone:716-553-4886
Mailing Address - Street 1:190 DEAN RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1308
Mailing Address - Country:US
Mailing Address - Phone:716-553-4886
Mailing Address - Fax:
Practice Address - Street 1:40 GARDENVILLE PKWY W STE 101
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1387
Practice Address - Country:US
Practice Address - Phone:716-324-5255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty