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Individual

CORRY LEA WIERZBOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPA-C

Contact information

Practice address
1026 UNION RD, WEST SENECA, NY 14224-3445
(716) 712-0851
(716) 712-0853
Mailing address
1026 UNION RD, WEST SENECA, NY 14224-3445
(716) 712-0851
(716) 712-0853

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007783-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02345155
NY
Enumeration date
06/21/2005
Last updated
07/24/2014
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