Healthcare Provider Details

I. General information

NPI: 1144905191
Provider Name (Legal Business Name): GRISHMA JALEMU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 MAIN ST
OLEAN NY
14760-1500
US

IV. Provider business mailing address

726 EXCHANGE ST STE 710
BUFFALO NY
14210-1464
US

V. Phone/Fax

Practice location:
  • Phone: 716-372-0141
  • Fax:
Mailing address:
  • Phone: 716-852-4772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT228638
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: