Healthcare Provider Details

I. General information

NPI: 1902807035
Provider Name (Legal Business Name): STACIE A CIFRANICK RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3615 SENECA ST
WEST SENECA NY
14224-3444
US

IV. Provider business mailing address

4488 CRESTRIDGE DR
HAMBURG NY
14075-6504
US

V. Phone/Fax

Practice location:
  • Phone: 716-675-2660
  • Fax: 716-675-2663
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number008142
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: