Healthcare Provider Details

I. General information

NPI: 1558631101
Provider Name (Legal Business Name): LORI BARR LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 08/05/2026
Certification Date:
Deactivation Date: 11/18/2025
Reactivation Date: 08/05/2026

III. Provider practice location address

155 LAWN AVE
BUFFALO NY
14207-1816
US

IV. Provider business mailing address

155 LAWN AVE
BUFFALO NY
14207-1816
US

V. Phone/Fax

Practice location:
  • Phone: 716-875-2904
  • Fax: 716-875-6717
Mailing address:
  • Phone: 716-875-2904
  • Fax: 716-875-6717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number306154
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: