Individual
AMEY R DZIULKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
100 HIGH STREET, SECTION B-2, BUFFALO, NY 14203
(716) 710-8266
(716) 710-8267
Mailing address
908 NIAGARA FALLS BLVD, SUITE 208, NORTH TONAWANDA, NY 14120
(716) 692-2160
(716) 213-0935
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006624-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026554801
UNIVERA
NY
01
—
000570173003
HEALTH NOW
NY
05
—
02074899
—
NY
01
—
161000580
NOVA
NY
01
—
9512201
IHA
NY
Enumeration date
07/30/2006
Last updated
08/31/2015
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