National Provider Identifier

Timothy J Bucklaew, PA

Timothy J Bucklaew, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Canandaigua, NY and a listed phone number of (585) 394-1960.

NPI 1407310741Canandaigua, NYPhysician Assistant

Profile Overview

NPI
1407310741
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
January 30, 2019
Last Updated
May 04, 2021

Practice Location

  • 229 Parrish St Ste 100
  • Canandaigua, NY 14424-1791

Phone: (585) 394-1960

Mailing Address

  • 57 Baier Dr
  • Rochester, NY 14606-5311

Specialties

  • Physician Assistant (363A00000X)

Endpoints

  • tbucklaew307316@direct.rochesterregional.org

    Direct Messaging Address | Direct | Canandaigua, NY 14424

Full Record
NPI
1407310741
Entity Type
Individual
Last Name
Bucklaew
First Name
Timothy
Middle Name
J
Credential
PA
Mailing Street Address
57 Baier Dr
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14606-5311
Mailing Country
US
Mailing Phone
(585) 755-3908
Practice Street Address
229 Parrish St Ste 100
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-1791
Practice Country
US
Practice Phone
(585) 394-1960
Practice Fax
(585) 393-9232
Enumeration Date
January 30, 2019
Last Updated
May 04, 2021
Sex
Male
Sole Proprietor
No
Certification Date
May 04, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)