Healthcare Provider Details

I. General information

NPI: 1740102367
Provider Name (Legal Business Name): ALEXIS NOELLE MEARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 ABBOTT RD
BUFFALO NY
14220-2039
US

IV. Provider business mailing address

28 VILLAGE VW
LANCASTER NY
14086-9344
US

V. Phone/Fax

Practice location:
  • Phone: 716-826-7000
  • Fax:
Mailing address:
  • Phone: 716-572-2450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: