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Individual

ERIC JOHN BREITWIESER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPA-C

Contact information

Practice address
ELM AND CARLTON STREETS, BUFFALO, NY 14263
(716) 845-2300
(716) 845-3423
Mailing address
ELM AND CARLTON STREETS, BUFFALO, NY 14263-0001
(716) 845-2300
(716) 845-3423

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
013126
NY
363AM0700X
Medical Physician Assistant
013126
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03083438
NY
Enumeration date
02/19/2009
Last updated
06/11/2019
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