Healthcare Provider Details

I. General information

NPI: 1194713693
Provider Name (Legal Business Name): HOPE OBERTEAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 11/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3040 WENDE RD
ALDEN NY
14004
US

IV. Provider business mailing address

3040 WENDE RD
ALDEN NY
14004-9717
US

V. Phone/Fax

Practice location:
  • Phone: 716-937-4000
  • Fax: 716-937-4244
Mailing address:
  • Phone: 716-937-4000
  • Fax: 716-937-4244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF330898
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: