Individual
MICHELLE THERESA BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
40 LA RIVIERE DR STE 201, BUFFALO, NY 14202-4344
(716) 893-1010
(716) 893-1002
Mailing address
1560 HARLEM RD, SUITE 3, CHEEKTOWAGA, NY 14206-1964
(716) 893-1010
(716) 893-1002
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F3336961
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9512100
IHA
—
Enumeration date
06/07/2006
Last updated
05/09/2022
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