Healthcare Provider Details

I. General information

NPI: 1487289542
Provider Name (Legal Business Name): NDANGA JOEL RAMAZANI BSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2020
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 NIAGARA ST
BUFFALO NY
14213-2001
US

IV. Provider business mailing address

255 DELAWARE AVE STE 300
BUFFALO NY
14202-2017
US

V. Phone/Fax

Practice location:
  • Phone: 716-710-4393
  • Fax: 716-856-5614
Mailing address:
  • Phone: 716-842-0440
  • Fax: 716-842-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number000
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: