MEDICARE: MS. ELLEN TERESA SPONHOLZ MSN, ANP

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	363LA2200X	Adult Health Nurse Practitioner	F302722-1	NY

General Provider Information

NPI Number	:	1942509898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELLEN TERESA SPONHOLZ MSN, ANP

Provider Business Mailing Address
First Line	:	101 KENTON RD
Second Line	:
City	:	KENMORE
State	:	NY
Zip	:	14217-1734
Country	:	US
Telephone Number	:	716-310-2277
Fax Number	:

Provider Business Practice Location Address
First Line	:	KENMORE MERCY HOSPITAL
Second Line	:	2950 ELMWOOD AVE
City	:	BUFFALO
State	:	NY
Zip	:	14217-1734
Country	:	US
Telephone Number	:	716-310-2277
Fax Number	:

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

Provider Enumeration Date	:	03/17/2011
Last Update Date	:	03/29/2026

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