Healthcare Provider Details

I. General information

NPI: 1487354320
Provider Name (Legal Business Name): NICHOLAS RICHARD SZAL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3085 HARLEM RD STE 200
CHEEKTOWAGA NY
14225-2591
US

IV. Provider business mailing address

6755 VAIL DR
HAMBURG NY
14075-6515
US

V. Phone/Fax

Practice location:
  • Phone: 716-844-5000
  • Fax: 716-844-5050
Mailing address:
  • Phone: 716-341-5234
  • 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: