Healthcare Provider Details

I. General information

NPI: 1538402698
Provider Name (Legal Business Name): PAUL C LOWMAN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 08/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 NIAGARA ST
BUFFALO NY
14213-2116
US

IV. Provider business mailing address

42 PLEASANT PLACE
BUFFALO NY
14208
US

V. Phone/Fax

Practice location:
  • Phone: 716-883-5344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number077792
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: