MEDICARE: NICHOLAS WILLIAM GEISLER PA-C, MPAS

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	028441-01	NY

General Provider Information

NPI Number	:	1790418440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS WILLIAM GEISLER PA-C, MPAS

Provider Business Mailing Address
First Line	:	3349 CREEKVIEW DR
Second Line	:
City	:	HAMBURG
State	:	NY
Zip	:	14075-3640
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2350 MAPLE RD STE 100
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-4080
Country	:	US
Telephone Number	:	716-839-8000
Fax Number	:

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

Provider Enumeration Date	:	07/08/2022
Last Update Date	:	07/08/2022

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