Provider Demographics
NPI:1760728158
Name:GORSKI, LEAH MARIE (PA)
Entity Type:Individual
Prefix:MISS
First Name:LEAH
Middle Name:MARIE
Last Name:GORSKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:60 CASTLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-2615
Mailing Address - Country:US
Mailing Address - Phone:716-998-9865
Mailing Address - Fax:
Practice Address - Street 1:1 JOHN JAMES AUDUBON PKWY
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1143
Practice Address - Country:US
Practice Address - Phone:716-204-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant