Provider Demographics
NPI:1558387175
Name:SKRABUCHA, JULIE R (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:R
Last Name:SKRABUCHA
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:R
Other - Last Name:SUTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPAS, RPA-C
Mailing Address - Street 1:276B MILLER ST
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4510
Mailing Address - Country:US
Mailing Address - Phone:716-465-5972
Mailing Address - Fax:
Practice Address - Street 1:4949 HARLEM RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2500
Practice Address - Country:US
Practice Address - Phone:716-204-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011255-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant