Healthcare Provider Details

I. General information

NPI: 1174939425
Provider Name (Legal Business Name): MICHAEL TWORKOWSKI PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 SWEET HOME RD STE 12
AMHERST NY
14228-2784
US

IV. Provider business mailing address

1416 SWEET HOME RD STE 12
AMHERST NY
14228-2784
US

V. Phone/Fax

Practice location:
  • Phone: 716-688-5088
  • Fax: 716-650-5744
Mailing address:
  • Phone: 716-688-5088
  • Fax: 716-650-7544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number017678
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number017678
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: