Healthcare Provider Details

I. General information

NPI: 1144271164
Provider Name (Legal Business Name): JOHN BIELINSKI JR. PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 E MAIN ST
WESTFIELD NY
14787-1104
US

IV. Provider business mailing address

189 E. MAIN ST
WESTFIELD NY
14787
US

V. Phone/Fax

Practice location:
  • Phone: 716-326-4921
  • Fax:
Mailing address:
  • Phone: 716-793-2202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number006366
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3447
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: