Healthcare Provider Details

I. General information

NPI: 1922472224
Provider Name (Legal Business Name): CHELSEA ALIDA PERCY P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHELSEA ALIDA SNYDER PA-C

II. Dates (important events)

Enumeration Date: 11/24/2015
Last Update Date: 05/18/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 YOUNGS RD STE 104
WILLIAMSVILLE NY
14221-8024
US

IV. Provider business mailing address

1150 YOUNGS RD STE 104
WILLIAMSVILLE NY
14221-8024
US

V. Phone/Fax

Practice location:
  • Phone: 716-636-7979
  • Fax: 716-636-7993
Mailing address:
  • Phone: 716-636-7979
  • Fax: 716-636-7993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number019068-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number019068
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: