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Individual

MRS. CARRIE DENISE CLINE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA CCCA

Contact information

Practice address
2128 ELMWOOD AVENUE, BUFFALO, NY 14207-1910
(416) 874-4500
(716) 874-8145
Mailing address
352 HUNTINGTON AVE, BUFFALO, NY 14214-1542
(416) 874-4500
(716) 874-8145

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
0018381
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00026873201
UNIVERA COMMERCIAL
01
000576115007
COMMUNITY BLUE
05
01465154
NY
01
P00187911
RAILROAD MEDICARE
Enumeration date
04/28/2006
Last updated
07/08/2007
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