National Provider Identifier
Colleen Mary Wirth, PHYSICIAN ASSISTANT
Colleen Mary Wirth, PHYSICIAN ASSISTANT is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Williamsville, NY and a listed phone number of (716) 630-1140.
Profile Overview
- NPI
- 1558946491
- Provider Type
- Individual
- Primary Specialty
- Medical Physician Assistant
- Enumeration Date
- March 12, 2021
- Last Updated
- May 11, 2021
Practice Location
- 425 Essjay RD Ste 180
- Williamsville, NY 14221-5782
Phone: (716) 630-1140
Mailing Address
- 425 Essjay RD Ste 170
- Williamsville, NY 14221-8235
Specialties
- Medical Physician Assistant (363AM0700X)
- Physician Assistant (363A00000X)
Endpoints
- Williamsville
Other Url | Williamsville, NY 14221
Full Record
- NPI
- 1558946491
- Entity Type
- Individual
- Last Name
- Wirth
- First Name
- Colleen
- Middle Name
- Mary
- Credential
- PHYSICIAN ASSISTANT
- Mailing Street Address
- 425 Essjay RD Ste 170
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-8235
- Mailing Country
- US
- Mailing Phone
- (716) 630-1219
- Practice Street Address
- 425 Essjay RD Ste 180
- Practice City
- Williamsville
- Practice State
- NY
- Practice ZIP Code
- 14221-5782
- Practice Country
- US
- Practice Phone
- (716) 630-1140
- Enumeration Date
- March 12, 2021
- Last Updated
- May 11, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- May 11, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Medical Physician Assistant (363AM0700X), Physician Assistant (363A00000X)