Healthcare Provider Details

I. General information

NPI: 1508250499
Provider Name (Legal Business Name): GAIL HUFFMAN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 MEADOW FARM
NORTH CHILI NY
14514-1322
US

IV. Provider business mailing address

408 WHITTIER RD
SPENCERPORT NY
14559-9746
US

V. Phone/Fax

Practice location:
  • Phone: 585-594-1083
  • Fax:
Mailing address:
  • Phone: 585-730-9071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number301442-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: