National Provider Identifier
Penelope Lyn McClurg, PHYSICIAN ASSISTANT
Penelope Lyn McClurg, PHYSICIAN ASSISTANT is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Williamsville, NY and a listed phone number of (716) 204-3200.
Profile Overview
- NPI
- 1144201476
- Provider Type
- Individual
- Primary Specialty
- Surgical Physician Assistant
- Enumeration Date
- November 14, 2005
- Last Updated
- February 06, 2024
Practice Location
- 111 N Maplemere RD Ste 100
- Williamsville, NY 14221-3182
Phone: (716) 204-3200
Mailing Address
- 4225 Genesee St
- Cheektowaga, NY 14225-1994
Specialties
- Surgical Physician Assistant (363AS0400X)
Full Record
- NPI
- 1144201476
- Entity Type
- Individual
- Last Name
- McClurg
- First Name
- Penelope
- Middle Name
- Lyn
- Name Prefix
- MS.
- Credential
- PHYSICIAN ASSISTANT
- Provider Other Last Name
- Ostolski
- Provider Other First Name
- Penelope
- Provider Other Middle Name
- Lyn
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 4225 Genesee St
- Mailing City
- Cheektowaga
- Mailing State
- NY
- Mailing ZIP Code
- 14225-1994
- Mailing Country
- US
- Mailing Phone
- (716) 204-3200
- Practice Street Address
- 111 N Maplemere RD Ste 100
- Practice City
- Williamsville
- Practice State
- NY
- Practice ZIP Code
- 14221-3182
- Practice Country
- US
- Practice Phone
- (716) 204-3200
- Practice Fax
- (716) 204-4337
- Enumeration Date
- November 14, 2005
- Last Updated
- February 06, 2024
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- February 06, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Surgical Physician Assistant (363AS0400X)
- Other Identifiers
- 005649 (NY, License)