Provider Demographics
NPI:1487437430
Name:DUBANIK, ASHLEIGH (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:DUBANIK
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 1:5882 MCKINLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-5413
Mailing Address - Country:US
Mailing Address - Phone:248-875-8962
Mailing Address - Fax:
Practice Address - Street 1:1150 YOUNGS RD STE 104
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8096
Practice Address - Country:US
Practice Address - Phone:716-636-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030430363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant