Martha Andres, RPA-C

Individual provider Active NPI Physician Assistant · Springville, NY

NPI 1902813629 · NPPES record last updated Sep 8, 2009

Key facts

NPI
1902813629
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
004656-1 (NY)
Practice address
168 W Main St
Springville, NY 14141-1016
Phone
(716) 592-4781
Fax
(716) 592-4429
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004656-1NYMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 004656-1 NY Yes

Addresses

Primary practice location

168 W Main St
Springville, NY 14141-1016

Mailing address

168 W Main St
Springville, NY 14141-1016
Phone (716) 592-4781

Other identifiers

IdentifierTypeStateIssuer
01531699MedicaidNY

Other providers in Springville, NY

All providers in Springville, NY · Physician Assistant in New York

Sources for this page

Verify at the official NPI Registry.