Healthcare Provider Details

I. General information

NPI: 1063709632
Provider Name (Legal Business Name): LINDSAY STRASSHEIM RPAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY MANDRINO

II. Dates (important events)

Enumeration Date: 07/05/2011
Last Update Date: 11/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7220 PORTER RD
NIAGARA FALLS NY
14304-1600
US

IV. Provider business mailing address

7220 PORTER RD
NIAGARA FALLS NY
14304-1600
US

V. Phone/Fax

Practice location:
  • Phone: 716-575-0075
  • Fax: 716-242-0611
Mailing address:
  • Phone: 716-575-0075
  • Fax: 716-242-0611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number014846
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: