1417441262 NPI number — SHERRY ANN VEROSTKO-SLAZAK DBA COMPASSIONATE HEALTHCARE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417441262 NPI number — SHERRY ANN VEROSTKO-SLAZAK DBA COMPASSIONATE HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHERRY ANN VEROSTKO-SLAZAK DBA COMPASSIONATE HEALTHCARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417441262
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1967 WEHRLE DR STE 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14221-8452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-458-0752
Provider Business Mailing Address Fax Number:
716-803-8568

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1967 WEHRLE DR STE 10
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14221-8452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-458-0752
Provider Business Practice Location Address Fax Number:
716-803-8568
Provider Enumeration Date:
06/15/2018

Additional Information

Authorized Official

Authorized Official Last Name:
VEROSTKO-SLAZAK
Authorized Official First Name:
SHERRY
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
ANP
Authorized Official Telephone Number:
716-458-0752

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  302553 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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