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General NPI Number Information
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NPI Number | 1124469432
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Entity Type | Individual
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Provider Name | PIETER SCHUYLER VANHORN MPAS, RPA-C
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Gender | Male
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 6 FOUNTAIN PLZ
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City | BUFFALO
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State | NY
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Zip | 14202-2211
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Country | US
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Telephone | 716-308-2557
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Fax |
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Provider Business Mailing Address
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Address Line | 22 WOODSTOCK RD
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City | GLENWOOD
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State | NY
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Zip | 14069-9631
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Country | US
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Telephone | 716-462-4488
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 012783
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | OA002466
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License Number State | PA
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