National Provider Identifier
Andrea Larsen
Andrea Larsen is listed in the NPPES registry with a primary specialty of Physician Assistant in Buffalo, NY and a listed phone number of (716) 626-0093.
Profile Overview
- NPI
- 1578050068
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- April 19, 2018
- Last Updated
- November 08, 2021
Practice Location
- 100 College Pkwy
- Buffalo, NY 14221-6800
Phone: (716) 626-0093
Mailing Address
- 4360 Rushford Dr
- Hamburg, NY 14075-3081
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1578050068
- Entity Type
- Individual
- Last Name
- Larsen
- First Name
- Andrea
- Mailing Street Address
- 4360 Rushford Dr
- Mailing City
- Hamburg
- Mailing State
- NY
- Mailing ZIP Code
- 14075-3081
- Mailing Country
- US
- Practice Street Address
- 100 College Pkwy
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14221-6800
- Practice Country
- US
- Practice Phone
- (716) 626-0093
- Enumeration Date
- April 19, 2018
- Last Updated
- November 08, 2021
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- November 08, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)