National Provider Identifier

Corey Costa, PA

Corey Costa, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Amherst, NY and a listed phone number of (716) 604-8487.

NPI 1891266102Amherst, NYPhysician Assistant

Profile Overview

NPI
1891266102
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
December 13, 2018
Last Updated
July 11, 2024

Practice Location

  • 3980A Sheridan Dr Ste 200
  • Amherst, NY 14226-1741

Phone: (716) 604-8487

Mailing Address

  • PO Box 488
  • Buffalo, NY 14240-0488

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1891266102
Entity Type
Individual
Last Name
Costa
First Name
Corey
Credential
PA
Mailing Street Address
PO Box 488
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14240-0488
Mailing Country
US
Mailing Phone
(716) 852-4772
Mailing Fax
(716) 980-8011
Practice Street Address
3980A Sheridan Dr Ste 200
Practice City
Amherst
Practice State
NY
Practice ZIP Code
14226-1741
Practice Country
US
Practice Phone
(716) 604-8487
Practice Fax
(716) 980-8011
Enumeration Date
December 13, 2018
Last Updated
July 11, 2024
Sex
Male
Sole Proprietor
No
Certification Date
July 11, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)