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General NPI Number Information
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NPI Number | 1003154543
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Entity Type | Individual
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Provider Name | NICOLE ANDRUS DAOM, L.AC.
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Gender | Female
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 135 DELAWARE AVE
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City | BUFFALO
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State | NY
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Zip | 14202-2416
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Country | US
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Telephone | 716-218-9338
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Fax |
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Provider Business Mailing Address
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Address Line | 149 SWAN ST UNIT 103
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City | BUFFALO
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State | NY
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Zip | 14203-2624
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Country | US
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Telephone | 614-218-1363
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 006927
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 65.000301
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00112000
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 198.001041
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License Number State | IL
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