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General NPI Number Information
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NPI Number | 1225924848
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Entity Type | Individual
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Provider Name | BRENDON JAMES EMMICK
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Gender | Male
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 326 ORCHARD PARK RD
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City | WEST SENECA
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State | NY
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Zip | 14224-2635
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Country | US
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Telephone | 716-828-0560
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Fax | 716-823-0751
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Provider Business Mailing Address
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Address Line | PO BOX 631
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City | ORCHARD PARK
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State | NY
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Zip | 14127-0631
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Country | US
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Telephone | 716-662-2040
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Fax | 716-662-0019
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 129241
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License Number State | NY
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