National Provider Identifier

Marielle Rebecca Wiede, PA

Marielle Rebecca Wiede, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Amherst, NY and a listed phone number of (716) 688-6500.

NPI 1811454960Amherst, NYPhysician Assistant

Profile Overview

NPI
1811454960
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
February 25, 2019
Last Updated
November 27, 2023

Practice Location

  • 2350 Maple RD Ste 100
  • Amherst, NY 14221-4080

Phone: (716) 688-6500

Mailing Address

  • 4770 E Becker RD
  • Collins, NY 14034-9761

Specialties

  • Physician Assistant (363A00000X)

Endpoints

  • marielle.wiede.1@19947.direct.athenahealth.com

    Direct Messaging Address | Direct | Latus Primary Care Medicine, PLLC Dba Latus Medical Care | Amherst, NY 14221

Full Record
NPI
1811454960
Entity Type
Individual
Last Name
Wiede
First Name
Marielle
Middle Name
Rebecca
Credential
PA
Mailing Street Address
4770 E Becker RD
Mailing City
Collins
Mailing State
NY
Mailing ZIP Code
14034-9761
Mailing Country
US
Mailing Phone
(716) 560-8831
Practice Street Address
2350 Maple RD Ste 100
Practice City
Amherst
Practice State
NY
Practice ZIP Code
14221-4080
Practice Country
US
Practice Phone
(716) 688-6500
Enumeration Date
February 25, 2019
Last Updated
November 27, 2023
Sex
Female
Sole Proprietor
No
Certification Date
December 12, 2019
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)