| NPI | 1639565674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANN REYNARD Office Manager 716-632-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 23018540) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |