National Provider Identifier

Trevor Deraney, PA-C

Trevor Deraney, 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) 248-1420.

NPI 1700055068Buffalo, NYPhysician Assistant

Profile Overview

NPI
1700055068
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
February 20, 2008
Last Updated
March 15, 2019

Practice Location

  • 237 Linwood Ave
  • Buffalo, NY 14209-2009

Phone: (716) 248-1420

Mailing Address

  • PO Box 488
  • Buffalo, NY 14240-0488

Specialties

  • Physician Assistant (363A00000X)
  • Physician Assistant (363A00000X)
Full Record
NPI
1700055068
Entity Type
Individual
Last Name
Deraney
First Name
Trevor
Name Prefix
Mr.
Credential
PA-C
Mailing Street Address
PO Box 488
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14240-0488
Mailing Country
US
Mailing Phone
(203) 944-1940
Mailing Fax
(203) 402-4192
Practice Street Address
237 Linwood Ave
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14209-2009
Practice Country
US
Practice Phone
(716) 248-1420
Practice Fax
(716) 248-2026
Enumeration Date
February 20, 2008
Last Updated
March 15, 2019
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X), Physician Assistant (363A00000X)
Other Identifiers
020626400 (FL), 03217214 (NY)