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NPI Code Detail

MEDICARE: JASON CHURCHILL

MEDICARE: JASON CHURCHILL
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1760337661
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON CHURCHILL
Provider Business Mailing Address
First Line : 55 DODGE RD
Second Line :
City : GETZVILLE
State : NY
Zip : 14068-1205
Country : US
Telephone Number : 716-831-2700
Fax Number :
Provider Business Practice Location Address
First Line : 3020 BAILEY AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14215-2814
Country : US
Telephone Number : 716-833-3622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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Directions to “ JASON CHURCHILL ” Practice Location

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