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General NPI Number Information
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NPI Number | 1720591332
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Entity Type | Individual
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Provider Name | KAYLEE WIECHELT
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Gender | Female
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 2609 THREE ROD RD
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City | EAST AURORA
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State | NY
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Zip | 14052-9571
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Country | US
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Telephone | 716-864-2556
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Fax |
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Provider Business Mailing Address
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Address Line | ELM AND CARLTON ST
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City | BUFFALO
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State | NY
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Zip | 14263-0001
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Country | US
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Telephone | 716-845-2300
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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 | 021617-1
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License Number State | NY
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