Healthcare Provider Details
I. General information
NPI: 1043296338
Provider Name (Legal Business Name): JENNIFER A MAY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/19/2005
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6507 TRANSIT RD SUITE A
EAST AMHERST NY
14051-1427
US
IV. Provider business mailing address
6507 TRANSIT RD SUITE A
EAST AMHERST NY
14051-1427
US
V. Phone/Fax
- Phone: 716-689-4377
- Fax: 716-689-4843
- Phone: 716-689-4377
- Fax: 716-689-4843
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | 009984 1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: