Individual
CHERYL PIETROMICCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
462 GRIDER ST, BUFFALO, NY 14215-3021
(716) 898-4803
Mailing address
140 MONARCH DR, AMHERST, NY 14226-1523
(716) 867-6381
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
009516
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026762101
EXCELLUS UNIVERA
NY
01
—
000527486006
HEALTH NOW
NY
01
—
9512451
INDEPENDENT HEALTH
NY
Enumeration date
06/05/2006
Last updated
10/11/2012
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