Individual
JAMES TKACIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
112 W MAIN ST, ALLEGANY, NY 14706-1204
(716) 373-0700
(716) 373-7270
Mailing address
112 W MAIN ST, ALLEGANY, NY 14706-1204
(716) 373-0700
(716) 373-7270
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0048831
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02503799
—
NY
Enumeration date
07/20/2006
Last updated
10/09/2018
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