Healthcare Provider Details

I. General information

NPI: 1851509186
Provider Name (Legal Business Name): URBAN WOMEN'S MEDICAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3580 SHERIDAN DR SUITE 130
AMHERST NY
14226-1645
US

IV. Provider business mailing address

3580 SHERIDAN DR SUITE 130
AMHERST NY
14226-1645
US

V. Phone/Fax

Practice location:
  • Phone: 716-835-7737
  • Fax: 716-835-3733
Mailing address:
  • Phone: 716-835-7737
  • Fax: 716-835-3733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number197364
License Number StateNY

VIII. Authorized Official

Name: MS. ELLEN DENISE DEVERE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 716-835-7737