Brendan Mazurek, PT DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

044891 Issued in NY

Practice address

40 George Karl Blvd Ste 140
Williamsville, NY 14221-7183

Phone

(716) 539-0888

Fax

(716) 539-0889

NPI assigned

Sep 10, 2019

Last updated

Oct 1, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1174172399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 8000 DEPT 314",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142670002",
            "telephone_number": "716-213-0772",
            "fax_number": "716-324-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 GEORGE KARL BLVD STE 140",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217183",
            "telephone_number": "716-539-0888",
            "fax_number": "716-539-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUREK",
        "first_name": "BRENDAN",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-10",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05899647",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian James May, RPA C
• Maya Devi Srivastava MD PH DPC
• Leah Maynard, PA-C
• Christopher Paul Mazur, PHARMD
• Allison Mazurek, PA-C
• June Mazurek, RN
• Frederick B McAdam, MD
• Doreen McAllister, LPN
• Bettyjo P McAuliffe, RPA C
• Paul McBride, M.D.

• Physical Therapist in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.