Individual
CAITLYN ELIZABETH ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5959 BIG TREE RD STE 108, ORCHARD PARK, NY 14127-2291
(716) 204-3200
Mailing address
4225 GENESEE ST, CHEEKTOWAGA, NY 14225-1994
(716) 204-3200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024440
NYS OFFICE OF PROFESSIONS
NY
Enumeration date
11/14/2019
Last updated
11/14/2019
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