National Provider Identifier
Pure Podiatry Of Wny PLLC
Pure Podiatry Of Wny PLLC is listed in the NPPES registry with a primary specialty of Podiatrist in Buffalo, NY and a listed phone number of (716) 897-3720.
Source: public NPPES record, last updated September 17, 2024. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1114382520
- Provider Type
- Organization
- Primary Specialty
- Podiatrist
- Enumeration Date
- December 30, 2015
- Last Updated
- September 17, 2024
Practice Location
- 1431 Hertel Ave
- Buffalo, NY 14216-2871
Phone: (716) 897-3720
Authorized Official
- Name
- Breeann N Wilson
- Title
- Owner
- Credentials
- DPM
- Phone
- (716) 897-3720
Specialties
- Podiatrist (213E00000X)
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Full Record
- NPI
- 1114382520
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Pure Podiatry Of Wny PLLC
- Mailing Street Address
- 1431 Hertel Ave
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14216-2871
- Mailing Country
- US
- Mailing Phone
- (716) 897-3720
- Mailing Fax
- (716) 897-3918
- Practice Street Address
- 1431 Hertel Ave
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14216-2871
- Practice Country
- US
- Practice Phone
- (716) 897-3720
- Practice Fax
- (716) 897-3918
- Enumeration Date
- December 30, 2015
- Last Updated
- September 17, 2024
- Authorized Official Last Name
- Wilson
- Authorized Official First Name
- Breeann
- Authorized Official Middle Name
- N
- Authorized Official Title
- Owner
- Authorized Official Phone
- (716) 897-3720
- Organization Subpart
- No
- Authorized Official Credential Text
- DPM
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- September 17, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Podiatrist (213E00000X)
- Other Identifiers
- 04485329 (NY)