National Provider Identifier
Shane Grayson, PA-C
Shane Grayson, 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) 986-9199.
Profile Overview
- NPI
- 1629760855
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- May 25, 2023
- Last Updated
- August 16, 2023
Practice Location
- 34 Benwood Ave
- Buffalo, NY 14214-1761
Phone: (716) 986-9199
Mailing Address
- 1519 Summit St
- White Oak, PA 15131-1705
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1629760855
- Entity Type
- Individual
- Last Name
- Grayson
- First Name
- Shane
- Credential
- PA-C
- Mailing Street Address
- 1519 Summit St
- Mailing City
- White Oak
- Mailing State
- PA
- Mailing ZIP Code
- 15131-1705
- Mailing Country
- US
- Practice Street Address
- 34 Benwood Ave
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14214-1761
- Practice Country
- US
- Practice Phone
- (716) 986-9199
- Enumeration Date
- May 25, 2023
- Last Updated
- August 16, 2023
- Sex
- Male
- Sole Proprietor
- Yes
- Taxonomy Group 1
- 193200000X Multi-Specialty Group
- Certification Date
- August 16, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)