Healthcare Provider Details

I. General information

NPI: 1639525280
Provider Name (Legal Business Name): LAURA MARY MCDONALD P.A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 MAPLE RD
AMHERST NY
14226-1027
US

IV. Provider business mailing address

4350 MAPLE RD
AMHERST NY
14226-1027
US

V. Phone/Fax

Practice location:
  • Phone: 716-829-3316
  • Fax:
Mailing address:
  • Phone: 716-829-3316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number019733
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: