Healthcare Provider Details

I. General information

NPI: 1215164785
Provider Name (Legal Business Name): VANESSA ELAINE HUFFMAN L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 06/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9424 TRANSIT RD
EAST AMHERST NY
14051-2216
US

IV. Provider business mailing address

125 EDWARD ST 3K
BUFFALO NY
14201-2130
US

V. Phone/Fax

Practice location:
  • Phone: 716-568-2139
  • Fax: 716-568-2106
Mailing address:
  • Phone: 716-510-7781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number021628
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: