Provider Demographics
NPI:1386950244
Name:WEREMBLEWSKI, THERESA ANN (FNP)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:ANN
Last Name:WEREMBLEWSKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:ANN
Other - Last Name:PFAFFENBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1173 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-7930
Mailing Address - Country:US
Mailing Address - Phone:716-875-5495
Mailing Address - Fax:
Practice Address - Street 1:4477 LAKE SHORE RD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1407
Practice Address - Country:US
Practice Address - Phone:716-442-2003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-28
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336353-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily