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General NPI Number Information
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NPI Number | 1154536852
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Entity Type | Individual
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Provider Name | MARCELLA LORRAINE BRIMO LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | BUFFALO GENERAL HOSPITAL 80 GOODRICH STREET
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City | BUFFALO
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State | NY
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Zip | 14203
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Country | US
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Telephone | 716-859-4573
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Fax | 716-859-2560
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Provider Business Mailing Address
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Address Line | 352 SPRINGVILLE AVENUE
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City | AMHERST
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State | NY
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Zip | 14226-2858
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Country | US
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Telephone | 716-834-3015
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R046250-1
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License Number State | NY
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