Healthcare Provider Details

I. General information

NPI: 1689222168
Provider Name (Legal Business Name): SINCERE SHERON WIGGINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 MAIN ST
BUFFALO NY
14209-2111
US

IV. Provider business mailing address

PO BOX 1861
BUFFALO NY
14240-1861
US

V. Phone/Fax

Practice location:
  • Phone: 716-884-9101
  • Fax: 716-884-7703
Mailing address:
  • Phone: 716-884-9101
  • Fax: 716-884-7703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number323093-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: