Provider Demographics
NPI:1942651468
Name:BAILEY, MONICA (PA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:180 PARK CLUB LN
Mailing Address - Street 2:SUITE 225
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5263
Mailing Address - Country:US
Mailing Address - Phone:716-839-5858
Mailing Address - Fax:716-839-5925
Practice Address - Street 1:180 PARK CLUB LN
Practice Address - Street 2:SUITE 225
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5263
Practice Address - Country:US
Practice Address - Phone:716-839-5858
Practice Address - Fax:716-839-5925
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2019-05-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY019810363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant