Healthcare Provider Details

I. General information

NPI: 1316607476
Provider Name (Legal Business Name): JOSEPH KRAJEWSKI PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2021
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 SHERIDAN DR
AMHERST NY
14226-1738
US

IV. Provider business mailing address

3925 SHERIDAN DR
AMHERST NY
14226-1738
US

V. Phone/Fax

Practice location:
  • Phone: 716-250-9999
  • Fax:
Mailing address:
  • Phone: 716-361-1083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number028847
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: