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Provider Information for 1316088206

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1316088206

Calendar   Last Updated:  2007-07-08
  Certification Date: 


Name Value
NPI 1316088206
Enumeration Date 2007-02-12
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 525 WASHINGTON ST
BUFFALO, NY 14203-1711
United States

Phone: 716-856-4494 | Fax: 716-842-1277
View Map External Link
Primary Practice Address 359 GRIDER ST
BUFFALO, NY 14215-3016
United States

Phone: 716-895-7715 | Fax: 716-893-1692
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other UNIVERA NY 00030241501
Other COMMUNITY BLUE 000506354005
Primary Taxonomy Selected Taxonomy State License Number
Yes 101Y00000X - Counselor