Basic Information
| Provider Information | |||||||||
| NPI: | 1205880770 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARYSEK | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4740 PARKER RD | ||||||||
| Address2: | |||||||||
| City: | HAMBURG | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140751160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7164450609 | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 HARLEM RD | ||||||||
| Address2: | |||||||||
| City: | WEST SENECA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142241151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163322121 | ||||||||
| FaxNumber: | 7163322122 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 04/25/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F333124 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 00026529702 | 01 | NY | UNIVERA HEALTHCARE NY HMO | OTHER | 9511855 | 01 | NY | INDEPENDENT HEALTH NY HMO | OTHER | 000560589003 | 01 | NY | BC/BS OF WNY | OTHER | 02505728 | 05 | NY | MEDICAID |