Healthcare Provider Details

I. General information

NPI: 1285877522
Provider Name (Legal Business Name): TERESA LOUISE DANFORTH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2009
Last Update Date: 09/07/2024
Certification Date: 09/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3085 HARLEM RD STE 200
CHEEKTOWAGA NY
14225-2591
US

IV. Provider business mailing address

3085 HARLEM RD STE 350
CHEEKTOWAGA NY
14225-2591
US

V. Phone/Fax

Practice location:
  • Phone: 716-844-5000
  • Fax: 716-844-5750
Mailing address:
  • Phone: 716-844-5000
  • Fax: 716-844-5750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number268218
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD483584
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: