Healthcare Provider Details

I. General information

NPI: 1982004990
Provider Name (Legal Business Name): MS. SONIA REBECCA HUTCHINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2014
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

472 EAST FERRY ST
BUFFALO NY
14208
US

IV. Provider business mailing address

472 EAST FERRY ST
BUFFALO NY
14208
US

V. Phone/Fax

Practice location:
  • Phone: 716-768-1701
  • Fax:
Mailing address:
  • Phone: 716-768-1701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: