ALICIA R BOMMERSBACH PHYSICIAN ASSISTANT NPI 1245244516

NPI Information

NPI: 1245244516
Provider Name: ALICIA R BOMMERSBACH, PHYSICIAN ASSISTANT
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: NEW YORK UNIVERSITY

PECOS Registration: Yes

Address:
295 ESSJAY RD
WILLIAMSVILLE, NY
ZIP 14221
Phone: (716) 630-1022
Get Directions

Alicia R Bommersbach, PHYSICIAN ASSISTANT is a medical physician assistant in Williamsville, NY with 18 years of experience. Alicia R Bommersbach, PHYSICIAN ASSISTANT NPI is 1245244516. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

295 ESSJAY RD
WILLIAMSVILLE, NY
ZIP 14221-216
Phone: (716) 630-1022
Fax: (716) 250-5958

The NPI 1245244516 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 7/29/2006 and was last updated on 11/2/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	011319	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02808822	MEDICAID	NEW YORK
2	00027739701	OTHER	NEW YORK	UNIVERA
3	000528705001	OTHER	NEW YORK	HEALTH NOW
4	9513979	OTHER	NEW YORK	INDEPENDENT HEALTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »