Provider Demographics
NPI:1720860703
Name:BECHT, KAITLYN (PA)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:BECHT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3725 N BUFFALO ST STE A
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1853
Mailing Address - Country:US
Mailing Address - Phone:716-662-2300
Mailing Address - Fax:716-662-2057
Practice Address - Street 1:3725 N BUFFALO ST STE A
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1853
Practice Address - Country:US
Practice Address - Phone:716-662-2300
Practice Address - Fax:716-662-2057
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY030869363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical