Individual
BRENT P MACZUGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
21 DOAT ST, BUFFALO, NY 14211-1612
(716) 892-2775
(716) 597-0554
Mailing address
184 BARTON ST, BUFFALO, NY 14213-1573
(716) 881-6191
(716) 881-6247
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA056791
PA
Other
Enumeration date
03/21/2014
Last updated
08/01/2023
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