National Provider Identifier
Krista Lauren Vanderwall, PA
Krista Lauren Vanderwall, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Williamsville, NY and a listed phone number of (716) 500-2663.
Profile Overview
- NPI
- 1073094769
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- August 22, 2018
- Last Updated
- November 27, 2023
Practice Location
- 100 College Pkwy Ste 160
- Williamsville, NY 14221-6800
Phone: (716) 500-2663
Mailing Address
- PO Box 448
- Buffalo, NY 14240-0488
Specialties
- Physician Assistant (363A00000X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1073094769
- Entity Type
- Individual
- Last Name
- Vanderwall
- First Name
- Krista
- Middle Name
- Lauren
- Credential
- PA
- Mailing Street Address
- PO Box 448
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14240-0488
- Mailing Country
- US
- Mailing Phone
- (716) 852-4772
- Practice Street Address
- 100 College Pkwy Ste 160
- Practice City
- Williamsville
- Practice State
- NY
- Practice ZIP Code
- 14221-6800
- Practice Country
- US
- Practice Phone
- (716) 500-2663
- Enumeration Date
- August 22, 2018
- Last Updated
- November 27, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- November 27, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X), Student in an Organized Health Care Education/Training Program (390200000X)