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Individual

NICHOLAS PETER BOSSERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6255 SHERIDAN DR STE 200, WILLIAMSVILLE, NY 14221-8096
(716) 636-7979
(716) 929-0192
Mailing address
6255 SHERIDAN DR STE 200, WILLIAMSVILLE, NY 14221-8096
(716) 636-7979
(716) 929-0192

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
023593
NY
363AM0700X
Medical Physician Assistant
Primary
023593
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05764672
NY
Enumeration date
07/09/2019
Last updated
04/14/2026
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