National Provider Identifier
Christine Marie Micciariello, PHYSICIAN ASSISTANT
Christine Marie Micciariello, 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) 631-2517.
Profile Overview
- NPI
- 1699896001
- Provider Type
- Individual
- Primary Specialty
- Medical Physician Assistant
- Enumeration Date
- April 03, 2007
- Last Updated
- December 06, 2021
Practice Location
- 325 Essjay RD
- Williamsville, NY 14221-8243
Phone: (716) 631-2517
Mailing Address
- 425 Essjay RD Ste 170
- Williamsville, NY 14221-8235
Specialties
- Medical Physician Assistant (363AM0700X)
- Physician Assistant (363A00000X)
Endpoints
- production@direct.buffalomedicalgroup.com
Direct Messaging Address | Williamsville, NY 14221
Full Record
- NPI
- 1699896001
- Entity Type
- Individual
- Last Name
- Micciariello
- First Name
- Christine
- Middle Name
- Marie
- Name Prefix
- MS.
- Credential
- PHYSICIAN ASSISTANT
- Provider Other Last Name
- Reynolds
- Provider Other First Name
- Christine
- Provider Other Middle Name
- Marie
- Provider Other Name Prefix Text
- MS.
- Provider Other Credential Text
- PHYSICIAN ASSISTANT
- Provider Other Last Name Type Code
- 1
- 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
- 325 Essjay RD
- Practice City
- Williamsville
- Practice State
- NY
- Practice ZIP Code
- 14221-8243
- Practice Country
- US
- Practice Phone
- (716) 631-2517
- Practice Fax
- (716) 634-5650
- Enumeration Date
- April 03, 2007
- Last Updated
- December 06, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- December 06, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Medical Physician Assistant (363AM0700X), Physician Assistant (363A00000X)