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NPI Code Detail

MEDICARE: MRS. RACHEL WALCZYK PA

MEDICARE: MRS. RACHEL WALCZYK PA
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
1363A00000XPhysician Assistant017604NY

General Provider Information

NPI Number : 1699181693
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RACHEL WALCZYK PA
Provider Business Mailing Address
First Line : 449 BROAD ST
Second Line :
City : SALAMANCA
State : NY
Zip : 14779-1455
Country : US
Telephone Number : 716-945-4770
Fax Number : 716-945-2393
Provider Business Practice Location Address
First Line : 449 BROAD ST
Second Line :
City : SALAMANCA
State : NY
Zip : 14779-1455
Country : US
Telephone Number : 716-945-4770
Fax Number : 716-945-2393
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2014
Last Update Date : 01/05/2017

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Directions to “ MRS. RACHEL WALCZYK PA” Practice Location

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