Provider Demographics
NPI:1962155325
Name:SIMON, DARIA ZOFIA (FNP)
Entity type:Individual
Prefix:MRS
First Name:DARIA
Middle Name:ZOFIA
Last Name:SIMON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DARIA
Other - Middle Name:ZOFIA
Other - Last Name:GORZUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81 CROFTON DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-4426
Mailing Address - Country:US
Mailing Address - Phone:716-572-7046
Mailing Address - Fax:
Practice Address - Street 1:818 ELLICOTT ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1021
Practice Address - Country:US
Practice Address - Phone:716-323-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF345888-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily