National Provider Identifier

Mariella Katherine Castro Begazo Hertwig, PA-C

Mariella Katherine Castro Begazo Hertwig, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Buffalo, NY and a listed phone number of (917) 261-4414.

NPI 1356712053Buffalo, NYPhysician Assistant

Profile Overview

NPI
1356712053
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
October 07, 2015
Last Updated
April 02, 2025

Practice Location

  • 199 Scott St Fl 8
  • Buffalo, NY 14204-2208

Phone: (917) 261-4414

Specialties

  • Physician Assistant (363A00000X)
  • Physician Assistant (363A00000X)
Full Record
NPI
1356712053
Entity Type
Individual
Last Name
Castro Begazo Hertwig
First Name
Mariella
Middle Name
Katherine
Credential
PA-C
Provider Other Last Name
Castro
Provider Other First Name
Mariella
Provider Other Middle Name
Katherine
Provider Other Credential Text
PA-C
Provider Other Last Name Type Code
2
Mailing Street Address
199 Scott St Fl 8
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14204-2208
Mailing Country
US
Mailing Phone
(917) 261-4414
Practice Street Address
199 Scott St Fl 8
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14204-2208
Practice Country
US
Practice Phone
(917) 261-4414
Enumeration Date
October 07, 2015
Last Updated
April 02, 2025
Sex
Female
Sole Proprietor
Yes
Certification Date
April 02, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X), Physician Assistant (363A00000X)