National Provider Identifier

Kelly Alice Emerson, PA-C

Kelly Alice Emerson, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Buffalo, NY and a listed phone number of (716) 645-9715.

NPI 1265273635Buffalo, NYPhysician Assistant

Profile Overview

NPI
1265273635
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
June 01, 2024
Last Updated
August 22, 2024

Practice Location

  • 77 Goodell St Ste 340
  • Buffalo, NY 14203-1243

Phone: (716) 645-9715

Mailing Address

  • 7823 Hayes Hollow RD
  • Colden, NY 14033-9776

Specialties

  • Physician Assistant (363A00000X)
  • Physician Assistant (363A00000X)
  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1265273635
Entity Type
Individual
Last Name
Emerson
First Name
Kelly
Middle Name
Alice
Name Prefix
MS.
Credential
PA-C
Mailing Street Address
7823 Hayes Hollow RD
Mailing City
Colden
Mailing State
NY
Mailing ZIP Code
14033-9776
Mailing Country
US
Practice Street Address
77 Goodell St Ste 340
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14203-1243
Practice Country
US
Practice Phone
(716) 645-9715
Enumeration Date
June 01, 2024
Last Updated
August 22, 2024
Sex
Female
Sole Proprietor
Yes
Certification Date
August 22, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X), Physician Assistant (363A00000X), Student in an Organized Health Care Education/Training Program (390200000X)