Healthcare Provider Details

I. General information

NPI: 1831473297
Provider Name (Legal Business Name): ERIN JO MCCUE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 FOUNTAIN PLZ
BUFFALO NY
14202-2211
US

IV. Provider business mailing address

6 FOUNTAIN PLZ
BUFFALO NY
14202-2211
US

V. Phone/Fax

Practice location:
  • Phone: 716-969-3241
  • Fax:
Mailing address:
  • Phone: 716-969-3241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number590131
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number339475
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: