National Provider Identifier
Miguel Socorro Sepulveda, CERA-5338
Miguel Socorro Sepulveda, CERA-5338 is listed in the NPPES registry with a primary specialty of Peer Specialist in Buffalo, NY and a listed phone number of (716) 553-4886.
Profile Overview
- NPI
- 1609694991
- Provider Type
- Individual
- Primary Specialty
- Peer Specialist
- Enumeration Date
- September 26, 2024
- Last Updated
- September 26, 2024
Practice Location
- 371 Delaware Ave
- Buffalo, NY 14202-1671
Phone: (716) 553-4886
Mailing Address
- 190 Dean RD
- Depew, NY 14043-1308
Specialties
- Peer Specialist (175T00000X)
Full Record
- NPI
- 1609694991
- Entity Type
- Individual
- Last Name
- Sepulveda
- First Name
- Miguel
- Middle Name
- Socorro
- Name Prefix
- Mr.
- Credential
- CERA-5338
- Mailing Street Address
- 190 Dean RD
- Mailing City
- Depew
- Mailing State
- NY
- Mailing ZIP Code
- 14043-1308
- Mailing Country
- US
- Mailing Phone
- (716) 553-4886
- Practice Street Address
- 371 Delaware Ave
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14202-1671
- Practice Country
- US
- Practice Phone
- (716) 553-4886
- Enumeration Date
- September 26, 2024
- Last Updated
- September 26, 2024
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- September 26, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Peer Specialist (175T00000X)