National Provider Identifier
Jeffrey M Park, PA-C
Jeffrey M Park, 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) 995-4450.
Profile Overview
- NPI
- 1376581561
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- June 02, 2006
- Last Updated
- October 24, 2019
Practice Location
- 701 Seneca St Ste 646C
- Buffalo, NY 14210-1351
Phone: (716) 995-4450
Mailing Address
- 100 High St
- Dept. Of Emergency Medicine
- Buffalo, NY 14203-1126
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1376581561
- Entity Type
- Individual
- Last Name
- Park
- First Name
- Jeffrey
- Middle Name
- M
- Name Prefix
- Mr.
- Credential
- PA-C
- Mailing Street Address
- 100 High St
- Mailing Address Line 2
- Dept. Of Emergency Medicine
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14203-1126
- Mailing Country
- US
- Mailing Phone
- (716) 859-1993
- Practice Street Address
- 701 Seneca St Ste 646C
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14210-1351
- Practice Country
- US
- Practice Phone
- (716) 995-4450
- Enumeration Date
- June 02, 2006
- Last Updated
- October 24, 2019
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)