Provider Demographics
NPI:1811453103
Name:CRAW, ONDRA ELIZABETH (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:ONDRA
Middle Name:ELIZABETH
Last Name:CRAW
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 MILLERSPORT HWY
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1219
Mailing Address - Country:US
Mailing Address - Phone:716-204-5933
Mailing Address - Fax:716-204-5934
Practice Address - Street 1:2235 MILLERSPORT HWY
Practice Address - Street 2:
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1219
Practice Address - Country:US
Practice Address - Phone:716-204-5933
Practice Address - Fax:716-204-5934
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant