Provider Demographics
NPI:1386626117
Name:DYBALSKI, ANDREW M (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:M
Last Name:DYBALSKI
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Gender:M
Credentials:RPA-C
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Mailing Address - Street 1:4225 GENESEE ST STE 400
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1994
Mailing Address - Country:US
Mailing Address - Phone:716-204-3200
Mailing Address - Fax:716-204-4337
Practice Address - Street 1:700 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1514
Practice Address - Country:US
Practice Address - Phone:716-854-5700
Practice Address - Fax:716-854-5800
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2021-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY009369363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP96420Medicare UPIN
NYPA0213Medicare ID - Type UnspecifiedMEDICARE #