Healthcare Provider Details

I. General information

NPI: 1043286875
Provider Name (Legal Business Name): ANN STACK STEINWALD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGH ST
BUFFALO NY
14203-1126
US

IV. Provider business mailing address

PO BOX 8000 DEPT 164
BUFFALO NY
14267-0002
US

V. Phone/Fax

Practice location:
  • Phone: 716-859-2244
  • Fax: 716-859-1112
Mailing address:
  • Phone: 716-692-3302
  • Fax: 716-213-0935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberF332042
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: