National Provider Identifier

Olivia Nicole Rutkowski, PA

Olivia Nicole Rutkowski, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Williamsville, NY and a listed phone number of (716) 697-2341.

NPI 1104402163Williamsville, NYPhysician Assistant

Profile Overview

NPI
1104402163
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
March 21, 2021
Last Updated
March 23, 2021

Practice Location

  • 10 Forestglen Cir
  • Williamsville, NY 14221-1359

Phone: (716) 697-2341

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1104402163
Entity Type
Individual
Last Name
Rutkowski
First Name
Olivia
Middle Name
Nicole
Name Prefix
MS.
Credential
PA
Provider Other Last Name
Rutkowski
Provider Other First Name
Olivia
Provider Other Middle Name
Nicole
Provider Other Name Prefix Text
MS.
Provider Other Credential Text
PA
Provider Other Last Name Type Code
2
Mailing Street Address
10 Forestglen Cir
Mailing City
Williamsville
Mailing State
NY
Mailing ZIP Code
14221-1359
Mailing Country
US
Mailing Phone
(716) 697-2341
Practice Street Address
10 Forestglen Cir
Practice City
Williamsville
Practice State
NY
Practice ZIP Code
14221-1359
Practice Country
US
Practice Phone
(716) 697-2341
Enumeration Date
March 21, 2021
Last Updated
March 23, 2021
Sex
Female
Sole Proprietor
No
Certification Date
March 23, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)