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

Individual provider Physician Assistant · NPI 1790864148

Stephanie T. Damodar, PA is a Physician Assistant in Buffalo, New York. Works from 2 locations. Licensed in New York and Virginia.

Licensed in
NY, VA
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

565 Abbott Rd
Buffalo, NY 14220-2039
Phone: (716) 725-1654
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7200 Glen Forest Dr Ste 106, Richmond, VA 23226-3768 — (804) 495-0053

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110003134 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 010938 (NY)

Record details

NPI number1790864148
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 6, 2006
Last updated in NPPESDecember 28, 2020
Certification dateDecember 28, 2020

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