Healthcare Provider Details

I. General information

NPI: 1144178526
Provider Name (Legal Business Name): TRAVERSIFY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3538 NORTH AVE
NIAGARA FALLS NY
14305
US

IV. Provider business mailing address

2914 PINE AVE STE 121
NIAGARA FALLS NY
14301-2444
US

V. Phone/Fax

Practice location:
  • Phone: 716-205-6488
  • Fax:
Mailing address:
  • Phone: 716-205-6488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH TRAVIS
Title or Position: OWNER
Credential: TRAVIS
Phone: 716-580-0073