Healthcare Provider Details

I. General information

NPI: 1568192003
Provider Name (Legal Business Name): SARAH ROSE WESOLOWSKI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3190 NIAGARA FALLS BLVD
AMHERST NY
14228-1639
US

IV. Provider business mailing address

50 CASCADE DR APT LEFT
AMHERST NY
14228-1826
US

V. Phone/Fax

Practice location:
  • Phone: 716-799-1002
  • Fax:
Mailing address:
  • Phone: 716-445-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: