Healthcare Provider Details

I. General information

NPI: 1750917092
Provider Name (Legal Business Name): ELIZABETH ANN EHRENREICH-HARE MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2020
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 DELAWARE AVE
BUFFALO NY
14209-2202
US

IV. Provider business mailing address

170 AUDUBON DR
BUFFALO NY
14226-4045
US

V. Phone/Fax

Practice location:
  • Phone: 716-431-5100
  • Fax:
Mailing address:
  • Phone: 716-361-4240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: