Healthcare Provider Details

I. General information

NPI: 1568645810
Provider Name (Legal Business Name): AMENEH HABIR WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 ABBOTT RD SUTIE 302
BUFFALO NY
14220-1700
US

IV. Provider business mailing address

2875 UNION RD SUITE 21
CHEEKTOWAGA NY
14227-1470
US

V. Phone/Fax

Practice location:
  • Phone: 716-828-3520
  • Fax: 716-828-3549
Mailing address:
  • Phone: 716-706-2034
  • Fax: 716-706-2035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF420854-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: