Provider Demographics
NPI:1801869284
Name:MASSING, ROBIN HEATHER (RPA-C)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:HEATHER
Last Name:MASSING
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:HEATHER
Other - Last Name:RASP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-857-8666
Mailing Address - Fax:716-630-1054
Practice Address - Street 1:295 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8216
Practice Address - Country:US
Practice Address - Phone:716-630-1050
Practice Address - Fax:716-250-5925
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008731-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02344838Medicaid
NYJ400066765Medicare PIN