Healthcare Provider Details

I. General information

NPI: 1811482714
Provider Name (Legal Business Name): EMILY JASZKA PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY KOWALSKI

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6255 SHERIDAN DR STE 200
WILLIAMSVILLE NY
14221-8096
US

IV. Provider business mailing address

6255 SHERIDAN DR STE 200
WILLIAMSVILLE NY
14221-8096
US

V. Phone/Fax

Practice location:
  • Phone: 716-636-7979
  • Fax: 716-929-0192
Mailing address:
  • Phone: 716-636-7979
  • Fax: 716-929-0192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: