Healthcare Provider Details

I. General information

NPI: 1114785326
Provider Name (Legal Business Name): ALICYNN L SCHWACH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 NIAGARA ST
BUFFALO NY
14213-2001
US

IV. Provider business mailing address

320 PORTER AVE
BUFFALO NY
14201-1032
US

V. Phone/Fax

Practice location:
  • Phone: 716-768-7600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: