MEDICARE: DANIELLE N PANZA PA-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	015571	NY
2	363AM0700X	Medical Physician Assistant	P83037	NY

General Provider Information

NPI Number	:	1548532849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE N PANZA PA-C

Provider Business Mailing Address
First Line	:	4927 MAIN ST STE 400
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-4081
Country	:	US
Telephone Number	:	716-877-7000
Fax Number	:	716-322-1164

Provider Business Practice Location Address
First Line	:	4927 MAIN ST STE 400
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-4081
Country	:	US
Telephone Number	:	716-877-7000
Fax Number	:	716-322-1164

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

Provider Enumeration Date	:	02/01/2012
Last Update Date	:	12/22/2021

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Directions to “ DANIELLE N PANZA PA-C” Practice Location

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