Provider Demographics
NPI:1457138927
Name:HARZYNSKI, CHRIS ALLEN (CASAC-T, CRPA-P)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:ALLEN
Last Name:HARZYNSKI
Suffix:
Gender:M
Credentials:CASAC-T, CRPA-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCRPA-P-6725175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist