Healthcare Provider Details

I. General information

NPI: 1780500777
Provider Name (Legal Business Name): LEAH CHRISTINE BENACK CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

155 LAWN AVE
BUFFALO NY
14207-1816
US

IV. Provider business mailing address

792 WEST AVE LOWR
BUFFALO NY
14213-2032
US

V. Phone/Fax

Practice location:
  • Phone: 716-875-2904
  • Fax: 716-332-0771
Mailing address:
  • Phone: 716-912-2552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number002499
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: