Provider Demographics
NPI:1336148709
Name:SZYMANSKI, CHAD E (DO)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:E
Last Name:SZYMANSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3799 COMMERCE CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:N TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2024
Mailing Address - Country:US
Mailing Address - Phone:716-693-5463
Mailing Address - Fax:716-693-6370
Practice Address - Street 1:3799 COMMERCE CT
Practice Address - Street 2:SUITE 100
Practice Address - City:N TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-2024
Practice Address - Country:US
Practice Address - Phone:716-693-5463
Practice Address - Fax:716-693-6370
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2013-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY224175207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02396665Medicaid
H84165Medicare UPIN
NY02396665Medicaid