Healthcare Provider Details

I. General information

NPI: 1720993793
Provider Name (Legal Business Name): NEIL BYRNE AGACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 ELMWOOD AVE
BUFFALO NY
14217-1390
US

IV. Provider business mailing address

44 BASSWOOD DR
BUFFALO NY
14227-2609
US

V. Phone/Fax

Practice location:
  • Phone: 716-447-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number312974
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: