Provider Demographics
NPI:1821102377
Name:PAWLOWSKI, JILL (MD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:PAWLOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ALCONA AVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-2201
Mailing Address - Country:US
Mailing Address - Phone:716-834-1193
Mailing Address - Fax:
Practice Address - Street 1:529 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2514
Practice Address - Country:US
Practice Address - Phone:716-366-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238179207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02792230Medicaid
NY060825000086OtherFIDELISCARE NEW YORK
NY00027681301OtherUNIVERA HEALTHCARE
NY3913986OtherINDEPENDENT HEALTH
NY000528709002OtherBLUE CROSS
NY3913986OtherINDEPENDENT HEALTH
NY00027681301OtherUNIVERA HEALTHCARE