National Provider Identifier

Kellie E Heftka, PA

Kellie E Heftka, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in West Seneca, NY and a listed phone number of (716) 668-3600.

NPI 1740381946West Seneca, NYPhysician Assistant

Profile Overview

NPI
1740381946
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
September 26, 2006
Last Updated
July 09, 2009

Practice Location

  • 120 Gardenville Pkwy W
  • West Seneca, NY 14224-1324

Phone: (716) 668-3600

Mailing Address

  • 120 Gardenville Pkwy W
  • Attn: Betty Piccillo
  • West Seneca, NY 14224-1324

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1740381946
Entity Type
Individual
Last Name
Heftka
First Name
Kellie
Middle Name
E
Credential
PA
Provider Other Last Name
Krawczyk
Provider Other First Name
Kellie
Provider Other Middle Name
E
Provider Other Credential Text
PA
Provider Other Last Name Type Code
1
Mailing Street Address
120 Gardenville Pkwy W
Mailing Address Line 2
Attn: Betty Piccillo
Mailing City
West Seneca
Mailing State
NY
Mailing ZIP Code
14224-1324
Mailing Country
US
Mailing Phone
(716) 857-6150
Mailing Fax
(716) 656-4074
Practice Street Address
120 Gardenville Pkwy W
Practice City
West Seneca
Practice State
NY
Practice ZIP Code
14224-1324
Practice Country
US
Practice Phone
(716) 668-3600
Practice Fax
(716) 656-4274
Enumeration Date
September 26, 2006
Last Updated
July 09, 2009
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)
Other Identifiers
190433DL (NY, Preferred Care #), 000528804001 (NY, Health Now BCBS #), 070111000100 (NY, Fidelis Care # Au), 070111000099 (NY, Fidelis Care # Sd), 9514067 (NY, Iha #)