Individual
MS. ELLEN DENISE DEVERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3580 SHERIDAN DR, SUITE 130, AMHERST, NY 14226-1645
(716) 835-7737
(716) 835-3733
Mailing address
3580 SHERIDAN DR, SUITE 130, AMHERST, NY 14226-1645
(716) 835-7737
(716) 835-3733
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
197364
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010044603
UNIVERA - NOT ACTIVE
NY
05
—
01760278
—
NY
01
—
0298886
GHI - INDIVIDUAL
NY
01
—
040426002348
FIDELIS
NY
01
—
0710873
IHA - NO LONGER ACTIVE
NY
Enumeration date
05/18/2007
Last updated
07/08/2007
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