Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
OMAR DWAYNE JACK, DO, PA-C
ActiveOMAR DWAYNE JACK, DO, PA-C is a Student (Health Education/Training) healthcare provider located in BUFFALO, New York. NPI 1144662909 is currently active in the NPPES registry. Verify at CMS.
Student (Health Education/Training) · BUFFALO, NY
Registration Details
- NPI Number
- 1144662909
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 22, 2013 (13.080086292152 yrs)
- Last Updated
- Mar 26, 2024
- Licenses
-
1109724 (GA)MA062538 (PA)
Practice Information
- Address
-
77 GOODELL ST STE 550BUFFALO, NY, 142031258Browse NY providers · Browse ZIP 14203
- Phone
- 7168296108
- Primary Specialty
-
Student (Health Education/Training)
390200000X
- Additional Specialty
- Medical Physician Assistant
- Additional Specialty
- Student (Health Education/Training)
Other Student (Health Education/Training) Providers in BUFFALO, NY
| Name | Credential | NPI |
|---|---|---|
| THARMAJINI SATHASIVAM | — | 1821287939 |
| ANDREA DUFORT | — | 1124297643 |
| DR. RUBEN GAGARIN | MD | 1801058060 |
| JOEL BEATTY | — | 1851557706 |
| DR. KUMIKO KITAOKA | M.D. | 1922254549 |
| DR. STEVEN JUSTIN DELUCA | MD | 1780833251 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.