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Individual

ANGEL M SZKUTAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
7060 ERIE RD, DERBY, NY 14047-9430
(716) 947-0408
Mailing address
7060 ERIE RD, DERBY, NY 14047-9430
(716) 947-0408

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015464
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01632562
NY
Enumeration date
02/12/2012
Last updated
10/27/2015
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