Provider Demographics
NPI:1740266139
Name:LAPLANTE, BRIAN PATRICK (PA-C)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:PATRICK
Last Name:LAPLANTE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:192 PARK CLUB LANE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-204-1101
Mailing Address - Fax:716-204-0914
Practice Address - Street 1:192 PARK CLUB LANE SUITE 100
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-204-1101
Practice Address - Fax:716-204-0914
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0001-04166363AS0400X
NY008447363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP59407Medicare UPIN