Healthcare Provider Details

I. General information

NPI: 1497038517
Provider Name (Legal Business Name): BARBARA THERESA BUCKLEY R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2011
Last Update Date: 09/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 LAWRENCE BELL DR
WILLIAMSVILLE NY
14221-7074
US

IV. Provider business mailing address

502 MEADOW DR
WEST SENECA NY
14224-1518
US

V. Phone/Fax

Practice location:
  • Phone: 716-204-0354
  • Fax:
Mailing address:
  • Phone: 716-867-0006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number284933-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: