Healthcare Provider Details

I. General information

NPI: 1982183661
Provider Name (Legal Business Name): KAITY MOLENDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 SPINDRIFT DR STE 100
WILLIAMSVILLE NY
14221-7894
US

IV. Provider business mailing address

297 SPINDRIFT DR STE 100
WILLIAMSVILLE NY
14221-7894
US

V. Phone/Fax

Practice location:
  • Phone: 716-831-2600
  • Fax: 716-831-2601
Mailing address:
  • Phone: 716-831-2600
  • Fax: 716-831-2601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: