Individual
CHRISTINE TERRYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
445 TREMONT ST, N TONAWANDA, NY 14120-6150
(716) 278-4000
Mailing address
50 ALCONA AVE, AMHERST, NY 14226-2201
(716) 754-1987
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007086
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02104290
—
NY
01
—
040426002261
FIDELIS
NY
Enumeration date
04/06/2007
Last updated
07/08/2007
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