Provider Demographics
NPI:1699954768
Name:COPELAND, ERIKA ELISHIA (PA)
Entity type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:ELISHIA
Last Name:COPELAND
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 1:120 GARDENVILLE PKWY W
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1324
Mailing Address - Country:US
Mailing Address - Phone:716-656-4250
Mailing Address - Fax:716-656-4074
Practice Address - Street 1:899 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1109
Practice Address - Country:US
Practice Address - Phone:716-878-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012012-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY012012-1OtherLICENSE #
NYPA2194Medicare PIN
NYPA2196Medicare PIN
NYPA2189Medicare PIN
NYPA2190Medicare PIN
NY012012-1OtherLICENSE #
NYPA2195Medicare PIN
NYPA2192Medicare PIN