Individual
JESSICA MARIE BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8750 TRANSIT RD, SUITE 105, EAST AMHERST, NY 14051-2610
(716) 636-1470
(716) 636-1423
Mailing address
36 N UNION RD, WILLIAMSVILLE, NY 14221-5383
(716) 636-1470
(716) 636-1423
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
012649-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012649-1
LICENSE
NY
Enumeration date
08/07/2008
Last updated
07/16/2013
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