Provider Demographics
NPI:1134569502
Name:CELLINO, ALEXANDRA M (PA)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:M
Last Name:CELLINO
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:425 ESSJAY RD
Mailing Address - Street 2:STE 170
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5782
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:3345 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1506
Practice Address - Country:US
Practice Address - Phone:716-656-4803
Practice Address - Fax:716-250-5932
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2018-01-31
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Provider Licenses
StateLicense IDTaxonomies
NY016614363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant