Provider Demographics
NPI:1689242109
Name:DONOVAN, ANDREA MARIE (PA-C)
Entity type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:MARIE
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:142 SARANAC AVE APT 11
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-2449
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical