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General NPI Number Information
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NPI Number | 1104172287
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Entity Type | Individual
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Provider Name | EMILY E MCGOWAN RPA-C
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Gender | Female
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Dates
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Enumeration Date | 07/26/2012
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Last Update Date | 07/06/2015
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Provider Practice Location Address
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Address Line | 1150 YOUNGS RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-8053
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Country | US
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Telephone | 716-572-7545
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Fax | 716-688-7345
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Provider Business Mailing Address
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Address Line | 30N UNION RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5367
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Country | US
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Telephone | 716-839-8000
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Fax | 716-839-8009
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 015717-1
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License Number State | NY
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