Healthcare Provider Details

I. General information

NPI: 1942984679
Provider Name (Legal Business Name): JENNA ELYSE DILIBERTA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980A SHERIDAN DR
AMHERST NY
14226-1741
US

IV. Provider business mailing address

3980 SHERIDAN DR
AMHERST NY
14226-1726
US

V. Phone/Fax

Practice location:
  • Phone: 716-250-2000
  • Fax:
Mailing address:
  • Phone: 716-250-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: