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General NPI Number Information
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NPI Number | 1033703269
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Entity Type | Individual
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Provider Name | KAILEE JUZDOWSKI PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/28/2021
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 726 EXCHANGE ST STE 710
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City | BUFFALO
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State | NY
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Zip | 14210-1464
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Country | US
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Telephone | 716-852-4772
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Fax |
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Provider Business Mailing Address
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Address Line | 24 OLD POST RD
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City | LANCASTER
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State | NY
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Zip | 14086-3243
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Country | US
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Telephone | 716-393-0468
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | NY
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