Omar Dwayne Jack, DO, PA-C is a student in an organized health care education training program in Buffalo, NY. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Omar Dwayne Jack, DO, PA-C NPI is 1144662909. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
77 GOODELL ST STE 550
BUFFALO, NY
ZIP 14203-258
Phone: (716) 829-6108
The NPI 1144662909 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 7/22/2013 and was last updated on 3/26/2024.