National Provider Identifier

Heather Marie Larson, PA

Heather Marie Larson, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Orchard Park, NY and a listed phone number of (716) 677-9220.

NPI 1003249269Orchard Park, NYPhysician Assistant

Profile Overview

NPI
1003249269
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
August 12, 2013
Last Updated
August 12, 2013

Practice Location

  • 3065 Southwestern Blvd
  • Suite 100
  • Orchard Park, NY 14127-1239

Phone: (716) 677-9220

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1003249269
Entity Type
Individual
Last Name
Larson
First Name
Heather
Middle Name
Marie
Credential
PA
Mailing Street Address
3065 Southwestern Blvd
Mailing Address Line 2
Suite 100
Mailing City
Orchard Park
Mailing State
NY
Mailing ZIP Code
14127-1239
Mailing Country
US
Mailing Phone
(716) 677-9220
Mailing Fax
(716) 677-9226
Practice Street Address
3065 Southwestern Blvd
Practice Address Line 2
Suite 100
Practice City
Orchard Park
Practice State
NY
Practice ZIP Code
14127-1239
Practice Country
US
Practice Phone
(716) 677-9220
Practice Fax
(716) 677-9226
Enumeration Date
August 12, 2013
Last Updated
August 12, 2013
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)