Provider Demographics
NPI:1356324016
Name:JOSLYN, LAURA E (RPA C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:E
Last Name:JOSLYN
Suffix:
Gender:F
Credentials:RPA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2332
Mailing Address - Country:US
Mailing Address - Phone:716-674-8502
Mailing Address - Fax:716-674-8504
Practice Address - Street 1:960 CENTER RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14224-2332
Practice Address - Country:US
Practice Address - Phone:716-674-8502
Practice Address - Fax:716-674-8504
Is Sole Proprietor?:No
Enumeration Date:2005-11-26
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006502363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000570185001OtherBLUE CROSS
NY000570185001OtherCOMM BLUE
NY9512235OtherINDEP HEALTH
NY00027195601OtherUNIVERA
NY9512235OtherINDEP HEALTH