National Provider Identifier
Jaclyn Marie Massicci, PA
Jaclyn Marie Massicci, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Buffalo, NY and a listed phone number of (716) 845-2300.
Profile Overview
- NPI
- 1912568361
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- June 26, 2019
- Last Updated
- January 13, 2026
Practice Location
- Elm And Carlton Streets
- Buffalo, NY 14263-0001
Phone: (716) 845-2300
Mailing Address
- Elm And Carlton St
- Buffalo, NY 14263-0001
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1912568361
- Entity Type
- Individual
- Last Name
- Massicci
- First Name
- Jaclyn
- Middle Name
- Marie
- Credential
- PA
- Provider Other Last Name
- Jones
- Provider Other First Name
- Jaclyn
- Provider Other Middle Name
- Marie
- Provider Other Credential Text
- PA
- Provider Other Last Name Type Code
- 5
- Mailing Street Address
- Elm And Carlton St
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14263-0001
- Mailing Country
- US
- Mailing Phone
- (716) 845-2300
- Practice Street Address
- Elm And Carlton Streets
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14263-0001
- Practice Country
- US
- Practice Phone
- (716) 845-2300
- Enumeration Date
- June 26, 2019
- Last Updated
- January 13, 2026
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 13, 2026
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)
- Other Identifiers
- 023543 (NY, Nys License)