National Provider Identifier
Shannon D Marzullo, ANP
Shannon D Marzullo, ANP is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner in Buffalo, NY and a listed phone number of (716) 849-8750.
Profile Overview
- NPI
- 1215250279
- Provider Type
- Individual
- Primary Specialty
- Adult Health Nurse Practitioner
- Enumeration Date
- March 04, 2010
- Last Updated
- February 11, 2019
Practice Location
- 50 Lakefront Blvd
- Suite 130
- Buffalo, NY 14202-4345
Phone: (716) 849-8750
Mailing Address
- 3332 Walden Ave
- Ste 110
- Depew, NY 14043-2400
Specialties
- Adult Health Nurse Practitioner (363LA2200X)
Full Record
- NPI
- 1215250279
- Entity Type
- Individual
- Last Name
- Marzullo
- First Name
- Shannon
- Middle Name
- D
- Name Prefix
- Mrs.
- Credential
- ANP
- Mailing Street Address
- 3332 Walden Ave
- Mailing Address Line 2
- Ste 110
- Mailing City
- Depew
- Mailing State
- NY
- Mailing ZIP Code
- 14043-2400
- Mailing Country
- US
- Mailing Phone
- (716) 849-8750
- Mailing Fax
- (716) 849-8757
- Practice Street Address
- 50 Lakefront Blvd
- Practice Address Line 2
- Suite 130
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14202-4345
- Practice Country
- US
- Practice Phone
- (716) 849-8750
- Practice Fax
- (716) 849-8757
- Enumeration Date
- March 04, 2010
- Last Updated
- February 11, 2019
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Adult Health Nurse Practitioner (363LA2200X)
- Other Identifiers
- 03600295 (NY)