Individual
MRS. COLLEEN M VACCARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5144 SHERIDAN DR, WILLIAMSVILLE, NY 14221-4648
(716) 632-2311
(716) 632-3140
Mailing address
5144 SHERIDAN DR, WILLIAMSVILLE, NY 14221-4648
(716) 632-2311
(716) 632-3140
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
009428-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026560704
UNIVERA
NY
01
—
000570453003
BCBS
NY
Enumeration date
09/28/2006
Last updated
10/15/2009
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