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NPI Code Detail

MEDICARE: CHRISTINE MARIE HERRMANN PA

MEDICARE: CHRISTINE MARIE HERRMANN PA
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
1363A00000XPhysician Assistant005376NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100026527501OTHERNYUNIVERA
2000570328003OTHERNYBC/BS
39512613OTHERNYIHA

General Provider Information

NPI Number : 1962462424
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE MARIE HERRMANN PA
Provider Business Mailing Address
First Line : 40 LA RIVIERE DR STE 201
Second Line :
City : BUFFALO
State : NY
Zip : 14202-4036
Country : US
Telephone Number : 716-893-1010
Fax Number :
Provider Business Practice Location Address
First Line : 40 LA RIVIERE DR STE 201
Second Line :
City : BUFFALO
State : NY
Zip : 14202-4344
Country : US
Telephone Number : 716-893-1010
Fax Number : 716-893-1002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2006
Last Update Date : 12/18/2024

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Directions to “ CHRISTINE MARIE HERRMANN PA” Practice Location

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