Healthcare Provider Details

I. General information

NPI: 1063517787
Provider Name (Legal Business Name): RICHARD P. MANIACE P.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2924 MAIN ST
BUFFALO NY
14214-1720
US

IV. Provider business mailing address

8205 MAIN ST STE 10
WILLIAMSVILLE NY
14221-6054
US

V. Phone/Fax

Practice location:
  • Phone: 716-837-0995
  • Fax: 716-837-1203
Mailing address:
  • Phone: 716-539-0789
  • Fax: 716-250-9090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF381303
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: