MEDICARE: ERIE COUNTY SOUTHEAST CORP V

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1376890798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIE COUNTY SOUTHEAST CORP V

Provider Business Mailing Address
First Line	:	BOX 631
Second Line	:	227 THORN AVENUE
City	:	ORCHARD PARK
State	:	NY
Zip	:	14202
Country	:	US
Telephone Number	:	716-662-2040
Fax Number	:	716-662-0019

Provider Business Practice Location Address
First Line	:	505 DELAWARE AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14202-1309
Country	:	US
Telephone Number	:	716-662-2040
Fax Number	:	716-662-0019

Authorized Official
Title or Position	:	PRESIDENT./CEO
Name	:	BRUCE C. NISBET
Credential	:
Telephone Number	:	716-662-2040

Provider Enumeration Date	:	08/06/2012
Last Update Date	:	07/19/2016

Similar Medicare Providers

1730318072 — EAST COAST ORTHOTIC & PROSTHETIC CORP
Practice Location Address:

505 DELAWARE AVE
BUFFALO, NY
14202-1309

Practice Phone: 716-856-5192
Practice Fax: 716-856-5246

1962840447 — BERNARD BEAUPIN MD PLLC
Practice Location Address:

505 DELAWARE AVE FL 2
BUFFALO, NY
14202-1309

Practice Phone: 716-447-6936
Practice Fax: 716-447-6937

1285243766 — MISS MEGAN GAYLE CRAWLEY ATC
Practice Location Address:

505 DELAWARE AVE
BUFFALO, NY
14202-1309

Practice Phone: 716-856-5192
Practice Fax:

1558338608 — MS. CAROL A CONKLIN LCSW-R
Practice Location Address:

610 ASHLAND AVE
BUFFALO, NY
14222-1309

Practice Phone: 716-883-7713
Practice Fax: 716-883-6718

1114324514 — REBEKAH CHEN LMHC
Practice Location Address:

610 ASHLAND AVE
BUFFALO, NY
14222-1309

Practice Phone: 716-883-7713
Practice Fax:

1265960561 — RYAN SAVINO
Practice Location Address:

610 ASHLAND AVE
BUFFALO, NY
14222-1309

Practice Phone: 716-883-7713
Practice Fax:

Directions to “ERIE COUNTY SOUTHEAST CORP V ” 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.