MEDICARE: CASSIDY ROSE SMITH 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	021000	NY

General Provider Information

NPI Number	:	1801318738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSIDY ROSE SMITH PA-C

Provider Business Mailing Address
First Line	:	4955 RED TAIL RUN
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-4183
Country	:	US
Telephone Number	:	716-866-8314
Fax Number	:

Provider Business Practice Location Address
First Line	:	2685 E HENRIETTA RD
Second Line	:
City	:	HENRIETTA
State	:	NY
Zip	:	14467-9370
Country	:	US
Telephone Number	:	716-204-4500
Fax Number	:

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

Provider Enumeration Date	:	07/12/2017
Last Update Date	:	07/12/2017

Similar Medicare Providers

1578506515 — MR. JON GOOTNICK PA
Practice Location Address:

2685 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-444-0058
Practice Fax: 585-444-0108

1588791156 — WALGREEN CO
Practice Location Address:

2665 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-359-3250
Practice Fax: 585-359-3267

1063655298 — MARC ALLEN HERBERT R.N.
Practice Location Address:

2685 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-444-0058
Practice Fax: 585-444-0108

1932423282 — MR. GARY WAYNE WILLISON RPH
Practice Location Address:

2665 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-359-3250
Practice Fax:

1558600841 — MS. LATANYA TENZA WHITE FNP
Practice Location Address:

2685 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-444-0058
Practice Fax:

1902254667 — STEPHANIE LYNNE WIERZBA
Practice Location Address:

2685 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-444-0058
Practice Fax:

Directions to “ CASSIDY ROSE SMITH PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.