National Provider Identifier

Nicholas John Green, PA-C

Nicholas John Green, PA-C is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Buffalo, NY and a listed phone number of (716) 986-9199.

NPI 1811580517Buffalo, NYMedical Physician Assistant

Profile Overview

NPI
1811580517
Provider Type
Individual
Primary Specialty
Medical Physician Assistant
Enumeration Date
February 15, 2021
Last Updated
February 15, 2021

Practice Location

  • 34 Benwood Ave
  • Buffalo, NY 14214-1761

Phone: (716) 986-9199

Specialties

  • Medical Physician Assistant (363AM0700X)
Full Record
NPI
1811580517
Entity Type
Individual
Last Name
Green
First Name
Nicholas
Middle Name
John
Name Prefix
Mr.
Credential
PA-C
Mailing Street Address
34 Benwood Ave
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14214-1761
Mailing Country
US
Mailing Phone
(716) 986-9199
Practice Street Address
34 Benwood Ave
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14214-1761
Practice Country
US
Practice Phone
(716) 986-9199
Enumeration Date
February 15, 2021
Last Updated
February 15, 2021
Sex
Male
Sole Proprietor
No
Certification Date
February 15, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Medical Physician Assistant (363AM0700X)