MEDICARE: JENNA ELYSE DILIBERTA 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	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1942984679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA ELYSE DILIBERTA PA-C

Provider Business Mailing Address
First Line	:	3980 SHERIDAN DR
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-1726
Country	:	US
Telephone Number	:	716-250-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3980A SHERIDAN DR
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-1741
Country	:	US
Telephone Number	:	716-250-2000
Fax Number	:

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

Provider Enumeration Date	:	06/13/2023
Last Update Date	:	06/18/2026

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