Healthcare Provider Details

I. General information

NPI: 1174927032
Provider Name (Legal Business Name): BRETT PINGER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2014
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
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

430 NIAGARA ST
BUFFALO NY
14201-1886
US

V. Phone/Fax

Practice location:
  • Phone: 716-345-4125
  • Fax:
Mailing address:
  • Phone: 716-856-2587
  • Fax: 716-856-2608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF406654-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number673553-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: