National Provider Identifier

Kathryn M Knisely, PA

Kathryn M Knisely, PA is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Williamsville, NY and a listed phone number of (716) 204-1101.

NPI 1669484440Williamsville, NYSurgical Physician Assistant

Profile Overview

NPI
1669484440
Provider Type
Individual
Primary Specialty
Surgical Physician Assistant
Enumeration Date
August 12, 2006
Last Updated
December 17, 2013

Practice Location

  • 192 Park Club Lane Suite 100
  • Williamsville, NY 14221

Phone: (716) 204-1101

Specialties

  • Surgical Physician Assistant (363AS0400X)
Full Record
NPI
1669484440
Entity Type
Individual
Last Name
Knisely
First Name
Kathryn
Middle Name
M
Name Prefix
MS.
Credential
PA
Provider Other Last Name
Prem
Provider Other First Name
Kathryn
Provider Other Middle Name
M
Provider Other Credential Text
PA
Provider Other Last Name Type Code
1
Mailing Street Address
192 Park Club Lane Suite 100
Mailing City
Williamsville
Mailing State
NY
Mailing ZIP Code
14221
Mailing Country
US
Mailing Phone
(716) 204-1101
Mailing Fax
(716) 204-0914
Practice Street Address
192 Park Club Lane Suite 100
Practice City
Williamsville
Practice State
NY
Practice ZIP Code
14221
Practice Country
US
Practice Phone
(716) 204-1101
Practice Fax
(716) 204-0914
Enumeration Date
August 12, 2006
Last Updated
December 17, 2013
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Surgical Physician Assistant (363AS0400X)