Individual
DEBORAH TELAAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
29 BUCYRUS DR, AMHERST, NY 14228-1944
(716) 691-8913
(716) 691-7013
Mailing address
29 BUCYRUS DR, MANAGED CARE DEPARTMENT, AMHERST, NY 14228-1944
(716) 691-8913
(716) 691-7013
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00030241501
UNIVERA
NY
01
—
000506354003
COMMUNITY BLUE
NY
Enumeration date
05/25/2006
Last updated
01/03/2013
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