| Paul Dejac Physician Pc | |
|
656 Elmwood Ave Buffalo NY 14222-1836 | |
| (716) 883-0515 | |
| (716) 883-8764 |
| Full Name | Paul Dejac Physician Pc |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 656 Elmwood Ave, Buffalo, New York |
| Authorized Official Name and Position | Lisa Achtziger (MANAGER) |
| Authorized Official Contact | 7168830515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Dejac Physician Pc 656 Elmwood Ave Buffalo NY 14222-1836 Ph: (716) 883-0515 | Paul Dejac Physician Pc 656 Elmwood Ave Buffalo NY 14222-1836 Ph: (716) 883-0515 |
| NPI Number | 1548971831 |
|---|---|
| Provider Enumeration Date | 12/08/2022 |
| Last Update Date | 09/13/2023 |
| Medicare PECOS PAC ID | 6709257108 |
|---|---|
| Medicare Enrollment ID | O20230123001626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548971831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
| Provider Name | Meggan K Shea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013268564 PECOS PAC ID: 7113153529 Enrollment ID: I20131113000888 |
| Provider Name | Marc Flierl |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386035194 PECOS PAC ID: 2961729108 Enrollment ID: I20150326001522 |
| Provider Name | Paul Dejac |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457796997 PECOS PAC ID: 2163719519 Enrollment ID: I20160928001653 |
| Provider Name | Christopher Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871926014 PECOS PAC ID: 6204189202 Enrollment ID: I20230427001668 |
| Provider Name | Andrew Bartz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144834433 PECOS PAC ID: 5496105736 Enrollment ID: I20231228001383 |
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