National Provider Identifier
Jordan Kathleen Fanara, PA-C
Jordan Kathleen Fanara, PA-C is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in West Seneca, NY and a listed phone number of (716) 712-0851.
Profile Overview
- NPI
- 1568146314
- Provider Type
- Individual
- Primary Specialty
- Medical Physician Assistant
- Enumeration Date
- June 12, 2023
- Last Updated
- June 20, 2023
Practice Location
- 1026 Union RD
- West Seneca, NY 14224-3445
Phone: (716) 712-0851
Mailing Address
- 5 S Fisher RD
- West Seneca, NY 14218-3640
Specialties
- Medical Physician Assistant (363AM0700X)
Full Record
- NPI
- 1568146314
- Entity Type
- Individual
- Last Name
- Fanara
- First Name
- Jordan
- Middle Name
- Kathleen
- Credential
- PA-C
- Mailing Street Address
- 5 S Fisher RD
- Mailing City
- West Seneca
- Mailing State
- NY
- Mailing ZIP Code
- 14218-3640
- Mailing Country
- US
- Mailing Phone
- (171) 660-5913
- Practice Street Address
- 1026 Union RD
- Practice City
- West Seneca
- Practice State
- NY
- Practice ZIP Code
- 14224-3445
- Practice Country
- US
- Practice Phone
- (716) 712-0851
- Enumeration Date
- June 12, 2023
- Last Updated
- June 20, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- June 20, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Medical Physician Assistant (363AM0700X)