National Provider Identifier

Connor Vanko, PA

Connor Vanko, PA is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Lockport, NY and a listed phone number of (716) 419-0400.

NPI 1275011066Lockport, NYSurgical Physician Assistant

Profile Overview

NPI
1275011066
Provider Type
Individual
Primary Specialty
Surgical Physician Assistant
Enumeration Date
August 02, 2018
Last Updated
October 18, 2025

Practice Location

  • 6001 Shimer Dr
  • Lockport, NY 14094-6412

Phone: (716) 419-0400

Mailing Address

  • 144 Genesee St
  • Buffalo, NY 14203-1560

Specialties

  • Surgical Physician Assistant (363AS0400X)
  • Physical Therapist (225100000X)
Full Record
NPI
1275011066
Entity Type
Individual
Last Name
Vanko
First Name
Connor
Credential
PA
Provider Other Last Name
Vankouwenberg
Provider Other First Name
Connor
Provider Other Credential Text
PT
Provider Other Last Name Type Code
1
Mailing Street Address
144 Genesee St
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14203-1560
Mailing Country
US
Mailing Phone
(716) 204-1101
Practice Street Address
6001 Shimer Dr
Practice City
Lockport
Practice State
NY
Practice ZIP Code
14094-6412
Practice Country
US
Practice Phone
(716) 419-0400
Enumeration Date
August 02, 2018
Last Updated
October 18, 2025
Sex
Male
Sole Proprietor
No
Certification Date
October 18, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Surgical Physician Assistant (363AS0400X), Physical Therapist (225100000X)