# THE WELLNESS INSTITUTE OF GREATER BUFFALO AND WESTERN NEW YORK, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184910655
- **Authorized official:** MR. PHILIP L. HABERSTRO (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (716) 851-4052

## Contact information

- **Practice address:** 65 NIAGARA SQ, ROOM 607, BUFFALO, NY 14202-3313
- **Practice address phone:** (716) 851-4052
- **Practice address fax:** (716) 851-4309
- **Mailing address:** 65 NIAGARA SQ, ROOM 607, BUFFALO, NY 14202-3313
- **Mailing address phone:** (716) 851-4052
- **Mailing address fax:** (716) 851-4309

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | — | NULL | Yes |
| 174H00000X | Health Educator | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2011
- **Last updated:** 06/23/2011