Healthcare Provider Details

I. General information

NPI: 1720904576
Provider Name (Legal Business Name): UPENDOLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 BURGARD PL UPPR
BUFFALO NY
14211-2424
US

IV. Provider business mailing address

60 BURGARD PL UPPR
BUFFALO NY
14211-2424
US

V. Phone/Fax

Practice location:
  • Phone: 716-602-2434
  • Fax:
Mailing address:
  • Phone: 716-602-2434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RASHAUN TUBBINS
Title or Position: CEO
Credential: RN
Phone: 716-602-2434