MEDICARE: WENDY A CALLEN RPAC

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	363AS0400X	Surgical Physician Assistant	0093671	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00068975	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000570428001	OTHER	NY	BLUE CROSS BLUE SHIELD
2	00026509501	OTHER	NY	UNIVERA HEALTHCARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	9512180	OTHER	NY	INDEPENDENT HEALTH

General Provider Information

NPI Number	:	1609851401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY A CALLEN RPAC

Provider Business Mailing Address
First Line	:	3980 SHERIDAN DR
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-1727
Country	:	US
Telephone Number	:	716-250-2000
Fax Number	:	716-250-2040

Provider Business Practice Location Address
First Line	:	3980 SHERIDAN DR
Second Line	:	SUITE 200
City	:	AMHERST
State	:	NY
Zip	:	14226-1727
Country	:	US
Telephone Number	:	716-250-2000
Fax Number	:

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	02/14/2017

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Directions to “ WENDY A CALLEN RPAC” Practice Location

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