Anthony D Tirabassi, PA student
Physician Assistant, Medical in Williamsville, NY. Individual provider (NPI-1).
NPI number1669224473
StatusActive
Last updated in NPPESJul 24, 2024
Details
- NPI
- 1669224473
- Entity type
- Individual (NPI-1)
- Name
- Anthony D Tirabassi
- Credential
- PA student
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 4, 2024
- Certification date
- Jul 24, 2024
- Last updated
- Jul 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 031947 | NY | Yes |
Practice location
40 George Karl BlvdWilliamsville, NY 14221-7183
Phone 716-218-1000
Mailing address
40 George Karl BlvdWilliamsville, NY 14221-7183
Phone 716-218-1000
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