Healthcare Provider Details

I. General information

NPI: 1164489043
Provider Name (Legal Business Name): CINDY M HERBERGER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 12/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2697 MAIN ST
BUFFALO NY
14214-1701
US

IV. Provider business mailing address

2697 MAIN ST
BUFFALO NY
14214-1701
US

V. Phone/Fax

Practice location:
  • Phone: 716-831-2200
  • Fax: 585-454-7001
Mailing address:
  • Phone: 716-831-2200
  • Fax: 585-454-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number420673
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: