Healthcare Provider Details

I. General information

NPI: 1669092987
Provider Name (Legal Business Name): DAWN ESCHNER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2020
Last Update Date: 04/17/2020
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 W HUMBOLDT PKWY
BUFFALO NY
14214-2605
US

IV. Provider business mailing address

741 DELAWARE AVE
BUFFALO NY
14209-2201
US

V. Phone/Fax

Practice location:
  • Phone: 716-835-9745
  • Fax:
Mailing address:
  • Phone: 716-218-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number00395308
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: