Individual provider Active NPI

Nikolina Izydorczak, RN

  • Registered Nurse
  • Cheektowaga, NY
National Provider Identifier
1316336704
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
800740-01 Issued in NY
Practice address
3851 Broadway Street
Cheektowaga, NY 14227-1120
Phone
(716) 225-0067
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 800740-01 NY Primary

Addresses

Primary practice location

3851 Broadway Street
Cheektowaga, NY 14227-1120

Mailing address

3851 Broadway Street
Cheektowaga, NY 14227-1120
Phone (716) 225-0067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
800740-01NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1316336704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 BROADWAY STREET",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142271120",
            "telephone_number": "716-225-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 BROADWAY STREET",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142271120",
            "telephone_number": "716-225-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZYDORCZAK",
        "first_name": "NIKOLINA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "800740-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.