Healthcare Provider Details

I. General information

NPI: 1225095979
Provider Name (Legal Business Name): BRIE ANNE SLAUGHTER RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 06/11/2021
Certification Date: 06/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 E ROBINSON RD STE 207
WEST AMHERST NY
14228-2044
US

IV. Provider business mailing address

3950 E ROBINSON RD SUITE 207
WEST AMHERST NY
14228-2041
US

V. Phone/Fax

Practice location:
  • Phone: 716-564-1111
  • Fax: 716-929-0194
Mailing address:
  • Phone: 716-564-1111
  • Fax: 716-564-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number010002
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: