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NPI Code Detail

MEDICARE: ELAINE CLUTTERBUCK CNM

MEDICARE: ELAINE CLUTTERBUCK CNM
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
1367A00000XAdvanced Practice Midwife000223NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100010252101OTHERNYUNIVERA
22012804OTHERNYFIDELIS
35008733OTHERNYIHA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5005600462OTHERNYBCBS

General Provider Information

NPI Number : 1124081070
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELAINE CLUTTERBUCK CNM
Provider Business Mailing Address
First Line : 397 LOUISIANA ST
Second Line :
City : BUFFALO
State : NY
Zip : 14204-2275
Country : US
Telephone Number : 716-847-6610
Fax Number : 716-854-3052
Provider Business Practice Location Address
First Line : 397 LOUISIANA ST
Second Line :
City : BUFFALO
State : NY
Zip : 14204-2275
Country : US
Telephone Number : 716-847-6610
Fax Number : 716-854-3052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 03/13/2013

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1861423584 — CHRISTINE D. HATEM N.P.
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Directions to “ ELAINE CLUTTERBUCK CNM” Practice Location

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