Healthcare Provider Details

I. General information

NPI: 1982875365
Provider Name (Legal Business Name): PAIN TREATMENT CONSULTANTS OF WNY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 N FRENCH RD STE 7
AMHERST NY
14228-2100
US

IV. Provider business mailing address

646 N FRENCH RD STE 7
AMHERST NY
14228-2100
US

V. Phone/Fax

Practice location:
  • Phone: 716-833-8184
  • Fax: 716-833-7746
Mailing address:
  • Phone: 716-870-3585
  • Fax: 716-833-7726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number199397
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number301682
License Number StateNY

VIII. Authorized Official

Name: ELLEN M BATTISTA SR.
Title or Position: OWER
Credential: DNS, ANP, PNP
Phone: 716-833-8184