Individual
MS. CHRISTINE MARIE MICCIARIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
325 ESSJAY RD, WILLIAMSVILLE, NY 14221-8243
(716) 631-2517
(716) 634-5650
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-8235
(716) 630-1219
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
007098-1
NY
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
04/03/2007
Last updated
12/06/2021
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