Healthcare Provider Details

I. General information

NPI: 1205792017
Provider Name (Legal Business Name): MARSHALL PIERRE LIM ND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/25/2025
Last Update Date: 12/25/2025
Certification Date: 12/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3734 DELAWARE AVE
KENMORE NY
14217-1002
US

IV. Provider business mailing address

3734 DELAWARE AVE
KENMORE NY
14217-1002
US

V. Phone/Fax

Practice location:
  • Phone: 716-873-8700
  • Fax: 716-873-8701
Mailing address:
  • Phone: 716-873-8700
  • Fax: 716-873-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1233
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: