Healthcare Provider Details

I. General information

NPI: 1720817273
Provider Name (Legal Business Name): ELLIOTT POHLMAN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 DELAWARE AVE
BUFFALO NY
14216-1705
US

IV. Provider business mailing address

2625 DELAWARE AVE
BUFFALO NY
14216-1705
US

V. Phone/Fax

Practice location:
  • Phone: 716-874-2759
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number052948
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: