Provider Demographics
NPI:1295750958
Name:ZAYAC, DANIEL (PA)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:ZAYAC
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11281 PARTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14080-9621
Mailing Address - Country:US
Mailing Address - Phone:716-898-5111
Mailing Address - Fax:716-898-5324
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-5111
Practice Address - Fax:716-898-5324
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003441-1208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0903OtherGROUP
NYCC8477Medicare PIN
NYAA0903OtherGROUP