Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mackenzie Moore, PA

Individual provider Physician Assistant · NPI 1154244465

Mackenzie Moore, PA is a Physician Assistant in Fredonia, New York. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2026
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

3780 Eagle St
Fredonia, NY 14063-9410
Phone: (716) 672-3030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 216 E Main St, Westfield, NY 14787-1133 — (716) 326-3240

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 036065-01 (NY)

Record details

NPI number1154244465
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 3, 2026
Last updated in NPPESAugust 3, 2026
Certification dateAugust 3, 2026
Mailing address3780 Eagle St, Fredonia, NY 14063-9410

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