Provider Demographics
NPI:1740265537
Name:CZAJKA, GREGORY A (RPA C)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:A
Last Name:CZAJKA
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Gender:M
Credentials:RPA C
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Mailing Address - Street 1:3085 HARLEM RD
Mailing Address - Street 2:STE 350
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2591
Mailing Address - Country:US
Mailing Address - Phone:716-844-5600
Mailing Address - Fax:716-844-5750
Practice Address - Street 1:180 PARK CLUB LN
Practice Address - Street 2:STE 100
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5263
Practice Address - Country:US
Practice Address - Phone:716-839-9402
Practice Address - Fax:716-839-3570
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2017-01-18
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
970007176OtherRAILROAD MEDICARE
NY00026511001OtherUNIVERA HEALTHCARE
NY01412591Medicaid
NY000570002005OtherBLUE CROSS BLUE SHIELD
NY9512079OtherINDEPENDENT HEALTH
970007176OtherRAILROAD MEDICARE
R53478Medicare UPIN