Individual
CASEY PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
608 WILLIAM ST, BUFFALO, NY 14206-1649
(716) 668-7051
(716) 668-7069
Mailing address
608 WILLIAM ST, BUFFALO, NY 14206-1649
(716) 858-8026
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015512
NY
363A00000X
Physician Assistant
—
—
Other
Enumeration date
01/03/2012
Last updated
07/18/2019
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