Provider Demographics
NPI:1811344005
Name:KOHLER, JO ANNA (PA)
Entity type:Individual
Prefix:
First Name:JO
Middle Name:ANNA
Last Name:KOHLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 HARLEM RD STE 240
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4031
Mailing Address - Country:US
Mailing Address - Phone:716-893-0333
Mailing Address - Fax:
Practice Address - Street 1:2625 HARLEM RD STE 240
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4031
Practice Address - Country:US
Practice Address - Phone:716-893-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant