Healthcare Provider Details

I. General information

NPI: 1902327521
Provider Name (Legal Business Name): JANA MARILYN MEDVES DOCTORATE OF AUDIOLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 DELAWARE AVE
KENMORE NY
14217
US

IV. Provider business mailing address

1001 MAIN STREET 3RD FLOOR
BUFFALO NY
14203
US

V. Phone/Fax

Practice location:
  • Phone: 716-871-9883
  • Fax: 716-871-9887
Mailing address:
  • Phone: 716-323-6030
  • Fax: 716-323-6706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number002793-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: