Healthcare Provider Details

I. General information

NPI: 1396343612
Provider Name (Legal Business Name): LAUREN A SISKAR FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2020
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 MAPLE RD
WILLIAMSVILLE NY
14221-3291
US

IV. Provider business mailing address

8396 STAHLEY RD
EAST AMHERST NY
14051-1599
US

V. Phone/Fax

Practice location:
  • Phone: 716-710-8266
  • Fax:
Mailing address:
  • Phone: 716-444-7819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1955258
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number733754
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: