Provider Demographics
NPI:1578788030
Name:CASE, ANDREW FREDERICK (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:FREDERICK
Last Name:CASE
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
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Mailing Address - Street 1:657 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1414
Mailing Address - Country:US
Mailing Address - Phone:716-884-3937
Mailing Address - Fax:
Practice Address - Street 1:327 BORDEN RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1714
Practice Address - Country:US
Practice Address - Phone:716-688-6343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY005914363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant