Healthcare Provider Details

I. General information

NPI: 1164819256
Provider Name (Legal Business Name): DANYEL BREWER RDN, CDN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 JOHN JAMES AUDUBON PKWY
AMHERST NY
14228-1143
US

IV. Provider business mailing address

PO BOX 831
GRAND ISLAND NY
14072-0831
US

V. Phone/Fax

Practice location:
  • Phone: 716-704-0684
  • Fax: 716-625-1236
Mailing address:
  • Phone: 716-704-0684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number008375-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: