Provider Demographics
NPI:1891928750
Name:LAMARCA, JILLIAN C (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:C
Last Name:LAMARCA
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Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:1150 YOUNGS RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8053
Mailing Address - Country:US
Mailing Address - Phone:716-636-7979
Mailing Address - Fax:716-636-7993
Practice Address - Street 1:3950 E ROBINSON RD
Practice Address - Street 2:SUITE 207
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14228-2041
Practice Address - Country:US
Practice Address - Phone:716-564-1111
Practice Address - Fax:716-564-1128
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2010-07-13
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Provider Licenses
StateLicense IDTaxonomies
NY013306-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03194983Medicaid
NY1891928750Medicare UPIN
NY1891928750Medicare PIN