Individual
ANDREA KLIMTZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
112 OLEAN ST, SUITE 220, EAST AURORA, NY 14052-2540
(716) 805-1072
(716) 805-1073
Mailing address
112 OLEAN ST, SUITE 220, EAST AURORA, NY 14052-2540
(716) 805-1072
(716) 805-1073
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010679
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027264901
UNIVERA
NY
01
—
000570550001
BC/BS
NY
05
—
02699627
—
NY
01
—
051031000028
FIDELIS
NY
01
—
172119BF
PREFERRED CARE
NY
01
—
9512871
IHA
NY
Enumeration date
03/09/2006
Last updated
03/11/2011
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