Provider Demographics
NPI:1740343219
Name:CZARNECKI, DONNA (PHD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:CZARNECKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3980 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1727
Mailing Address - Country:US
Mailing Address - Phone:716-250-2000
Mailing Address - Fax:716-250-2040
Practice Address - Street 1:200 STERLING DR
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1558
Practice Address - Country:US
Practice Address - Phone:716-250-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011196103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000511566002OtherBLUE CROSS & BLUE SHIELD
NY01375259Medicaid
NY9705954OtherINDEPENDENT HEALTH
NYS11196OtherWCB
NM680013208OtherRAILROAD MEDICARE
NY00020012701OtherUNIVERA
NY01375259Medicaid
NM680013208OtherRAILROAD MEDICARE