Provider Demographics
NPI:1730178088
Name:NOCEK, AMBER MICHELLE (PA-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:MICHELLE
Last Name:NOCEK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MICHELLE
Other - Last Name:GAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:525 WHEATFIELD ST STE 10
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-7034
Mailing Address - Country:US
Mailing Address - Phone:716-692-7156
Mailing Address - Fax:
Practice Address - Street 1:525 WHEATFIELD ST STE 10
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-7034
Practice Address - Country:US
Practice Address - Phone:716-692-7156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY363A00000X
NY014628-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant