Provider Demographics
NPI:1548532849
Name:PANZA, DANIELLE N (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:N
Last Name:PANZA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4927 MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4081
Mailing Address - Country:US
Mailing Address - Phone:716-877-7000
Mailing Address - Fax:716-322-1164
Practice Address - Street 1:4927 MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4081
Practice Address - Country:US
Practice Address - Phone:716-877-7000
Practice Address - Fax:716-322-1164
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015571363A00000X
NYP83037363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant