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General NPI Number Information
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NPI Number | 1669939849
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Entity Type | Individual
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Provider Name | JOHN J SLISZ PA
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Gender | Male
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 02/17/2024
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Provider Practice Location Address
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Address Line | 5959 BIG TREE RD STE 102
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City | ORCHARD PARK
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State | NY
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Zip | 14127-2291
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Country | US
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Telephone | 716-308-9640
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Fax | 862-212-1997
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Provider Business Mailing Address
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Address Line | 5959 BIG TREE RD STE 102
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City | ORCHARD PARK
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State | NY
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Zip | 14127-2291
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Country | US
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Telephone | 716-308-9640
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Fax | 862-212-1997
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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 | 023312
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License Number State | NY
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