MEDICARE: MRS. BRIE ANNE SLAUGHTER RPA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	010002	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225095979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRIE ANNE SLAUGHTER RPA-C

Provider Business Mailing Address
First Line	:	3950 E ROBINSON RD
Second Line	:	SUITE 207
City	:	WEST AMHERST
State	:	NY
Zip	:	14228-2041
Country	:	US
Telephone Number	:	716-564-1111
Fax Number	:	716-564-1128

Provider Business Practice Location Address
First Line	:	3950 E ROBINSON RD STE 207
Second Line	:
City	:	WEST AMHERST
State	:	NY
Zip	:	14228-2044
Country	:	US
Telephone Number	:	716-564-1111
Fax Number	:	716-929-0194

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	06/11/2021

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