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NPI Code Detail

MEDICARE: MRS. JAMIE C INTERLICHIA PA-C

MEDICARE:  MRS. JAMIE C INTERLICHIA  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant012866NY

General Provider Information

NPI Number : 1124278841
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAMIE C INTERLICHIA PA-C
Provider Business Mailing Address
First Line : ELM AND CARLTON ST
Second Line :
City : BUFFALO
State : NY
Zip : 14263
Country : US
Telephone Number : 716-845-2300
Fax Number :
Provider Business Practice Location Address
First Line : 2157 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14214-2648
Country : US
Telephone Number : 716-862-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2008
Last Update Date : 01/13/2026

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Directions to “ MRS. JAMIE C INTERLICHIA PA-C” Practice Location

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