Healthcare Provider Details

I. General information

NPI: 1497850911
Provider Name (Legal Business Name): DENT NEUROLOGIC GROUP LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 06/02/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 SHERIDAN DR SUITE 200
AMHERST NY
14226-1727
US

IV. Provider business mailing address

3980 SHERIDAN DR SUITE B
AMHERST NY
14226-1727
US

V. Phone/Fax

Practice location:
  • Phone: 716-250-2000
  • Fax:
Mailing address:
  • Phone: 716-250-2000
  • Fax: 716-250-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNY
# 9
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number StateNY

VIII. Authorized Official

Name: MELISSA PALMIERO
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 716-250-6035