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Organization
PURE PODIATRY OF WNY PLLC
Active
Organization
PURE PODIATRY OF WNY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREEANN N WILSON DPM (OWNER)
(716) 897-3720
Entity
Organization
Contact information
Practice address
1431 HERTEL AVE, BUFFALO, NY 14216-2871
(716) 897-3720
(716) 897-3918
Mailing address
1431 HERTEL AVE, BUFFALO, NY 14216-2871
(716) 897-3720
(716) 897-3918
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
006328
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04485329
—
NY
Enumeration date
12/30/2015
Last updated
09/17/2024
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