Provider Demographics
NPI:1336826791
Name:PYC, CECELIA (PA-C)
Entity type:Individual
Prefix:
First Name:CECELIA
Middle Name:
Last Name:PYC
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 GENESEE ST FL 3
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1560
Mailing Address - Country:US
Mailing Address - Phone:716-601-3600
Mailing Address - Fax:716-601-3620
Practice Address - Street 1:5290 MILITARY RD STE 10A
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-1983
Practice Address - Country:US
Practice Address - Phone:716-284-3278
Practice Address - Fax:716-601-3620
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16974363A00000X
NY033469363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant