Provider Demographics
NPI:1508144288
Name:AMBORSKI, JESSICA C (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:C
Last Name:AMBORSKI
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:C
Other - Last Name:DREXINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICIAN ASSISTANT
Mailing Address - Street 1:3980 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1727
Mailing Address - Country:US
Mailing Address - Phone:716-250-2000
Mailing Address - Fax:716-250-2040
Practice Address - Street 1:200 STERLING DR
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1577
Practice Address - Country:US
Practice Address - Phone:716-250-2000
Practice Address - Fax:716-250-2040
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03425165Medicaid
NYF90954Medicare UPIN
NY03425165Medicaid