Provider Demographics
NPI:1134105422
Name:MAY, BRIAN JAMES (RPA C)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:JAMES
Last Name:MAY
Suffix:
Gender:M
Credentials:RPA C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:550 ORCHARD PARK RD
Mailing Address - Street 2:STE A105
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2646
Mailing Address - Country:US
Mailing Address - Phone:716-677-6000
Mailing Address - Fax:716-677-6006
Practice Address - Street 1:180 PARK CLUB LN
Practice Address - Street 2:STE 100
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5263
Practice Address - Country:US
Practice Address - Phone:716-839-9402
Practice Address - Fax:716-839-3570
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007254 1363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026523401OtherUNIVERA HEALTHCARE
NY9512053OtherINDEPENDENT HEALTH
P00075047OtherRAILROAD MEDICARE
NY02343213Medicaid
NY000570248003OtherBLUE CROSS BLUE SHIELD
NY02343213Medicaid
NY00026523401OtherUNIVERA HEALTHCARE