Lee Anne Blevins Zajac
Individual provider Active NPI Contractor · Canton, NY
NPI 1184343162 · NPPES record last updated Aug 24, 2022
Key facts
- NPI
- 1184343162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 80 State Highway 310 Ste 2
Canton, NY 13617-1476 - Phone
- (315) 386-2325
- Fax
- (315) 386-2744
- NPI assigned
- Aug 24, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
80 State Highway 310 Ste 2
Canton, NY 13617-1476
Mailing address
80 State Highway 310 Ste 2
Canton, NY 13617-1476
Phone (315) 386-2325
Other providers in Canton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.