MEDICARE: CAROL GARVIN-LEASE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	005320-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104193572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL GARVIN-LEASE

Provider Business Mailing Address
First Line	:	4339 BEETOW DRIVE
Second Line	:
City	:	HAMBURG
State	:	NY
Zip	:	14075
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3780 S PARK AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14219-1805
Country	:	US
Telephone Number	:	716-926-1750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2011
Last Update Date	:	11/29/2011

Similar Medicare Providers

1164790739 — ANNA M LOVE RN
Practice Location Address:

3780 S PARK AVE
BUFFALO, NY
14219-1805

Practice Phone: 716-926-1750
Practice Fax:

1477664126 — MS. ANDREA L. FRYS LCSW
Practice Location Address:

3780 S PARK AVE
BLASDELL, NY
14219-1805

Practice Phone: 716-926-1750
Practice Fax:

1003995788 — BUFFALO PRESCRIPTION SHOP, INC
Practice Location Address:

431 FORT ST
BUFFALO, WY
82834-1805

Practice Phone: 307-684-7003
Practice Fax: 307-684-7348

1376609313 — DR. DANILO B SALDANA M.D.
Practice Location Address:

993 DELAWARE AVE
BUFFALO, NY
14209-1805

Practice Phone: 716-882-1160
Practice Fax: 716-882-0120

1811313877 — MS. TIFFANY MARIE WALTON LPN
Practice Location Address:

149 VIRGIL AVE
BUFFALO, NY
14216-1805

Practice Phone: 716-936-1873
Practice Fax:

1871003483 — DR. CHADWICK BARDWELL SOMMERS PHARM D
Practice Location Address:

431 FORT ST
BUFFALO, WY
82834-1805

Practice Phone: 307-684-7003
Practice Fax:

Directions to “ CAROL GARVIN-LEASE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.