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NPI Code Detail

MEDICARE: GATEWAY-LONGVIEW

MEDICARE: GATEWAY-LONGVIEW
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
1251S00000XCommunity/Behavioral Health Agency867311141NY

General Provider Information

NPI Number : 1124418306
Entity Type Code : Organization
Provider Name (Legal Business Name) : GATEWAY-LONGVIEW
Provider Business Mailing Address
First Line : 297 PARAMOUNT PKWY
Second Line :
City : BUFFALO
State : NY
Zip : 14223-1074
Country : US
Telephone Number : 716-725-1630
Fax Number :
Provider Business Practice Location Address
First Line : 10 SYMPHONY CIR
Second Line :
City : BUFFALO
State : NY
Zip : 14201-1363
Country : US
Telephone Number : 716-783-3230
Fax Number :
Authorized Official
Title or Position : SCHOOL PSYCHOLOGIST
Name : CARMELINA BUFALINO
Credential : MS, CAS
Telephone Number : 716-783-3230
Provider Enumeration Date : 01/27/2015
Last Update Date : 01/27/2015

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Directions to “GATEWAY-LONGVIEW ” Practice Location

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