Individual
ANDREW JOHN MIKAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
ELM AND CARLTON STREETS, BUFFALO, NY 14263
(716) 845-2300
Mailing address
ELM AND CARLTON STREETS, BUFFALO, NY 14263-0001
(716) 845-2300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
021805
NY
363AS0400X
Surgical Physician Assistant
Primary
021805
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05077761
—
NY
Enumeration date
02/07/2018
Last updated
01/22/2021
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