Healthcare Provider Details

I. General information

NPI: 1124135421
Provider Name (Legal Business Name): SHERI A EGELI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3495 BAILEY AVE
BUFFALO NY
14215-1129
US

IV. Provider business mailing address

12387 RIDGE RD
MEDINA NY
14103-9626
US

V. Phone/Fax

Practice location:
  • Phone: 716-862-8881
  • Fax:
Mailing address:
  • Phone: 585-356-5532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3030448
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: