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General NPI Number Information
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NPI Number | 1730052119
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Entity Type | Organization
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Legal Business Name | RESTORED CROWN LLC
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 2658 DELEWARE AVE. STE. 6
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City | BUFFALO
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State | NY
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Zip | 14216
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Country | US
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Telephone | 716-339-3107
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Fax |
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Provider Business Mailing Address
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Address Line | 4498 MAIN ST STE 4
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City | BUFFALO
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State | NY
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Zip | 14226-3826
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LONNESHA WILSON-MCDANIELS
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Credential | COSMETOLOGIST
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Telephone | 716-703-1755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number |
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License Number State |
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