National Provider Identifier

Nycole Brong, PA

Nycole Brong, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Amherst, NY and a listed phone number of (716) 689-1901.

NPI 1790765741Amherst, NYPhysician Assistant

Profile Overview

NPI
1790765741
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
January 18, 2006
Last Updated
July 08, 2007

Practice Location

  • 207 Commerce Dr
  • Amherst, NY 14228-2302

Phone: (716) 689-1901

Mailing Address

  • 462 Grider St
  • Erie County Medical Center
  • Buffalo, NY 14215-3021

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1790765741
Entity Type
Individual
Last Name
Brong
First Name
Nycole
Credential
PA
Provider Other Last Name
Agnello
Provider Other First Name
Nycole
Provider Other Credential Text
PA
Provider Other Last Name Type Code
1
Mailing Street Address
462 Grider St
Mailing Address Line 2
Erie County Medical Center
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14215-3021
Mailing Country
US
Mailing Phone
(716) 898-3525
Practice Street Address
207 Commerce Dr
Practice City
Amherst
Practice State
NY
Practice ZIP Code
14228-2302
Practice Country
US
Practice Phone
(716) 689-1901
Enumeration Date
January 18, 2006
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
X
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)
Other Identifiers
02343795 (NY)