Individual
CHRISTINE MARIE WECKERLE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1540 MAPLE RD, WILLIAMSVILLE, NY 14221-3647
(716) 510-1629
Mailing address
43 TIMBERLAKE DR, ORCHARD PARK, NY 14127-3573
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
175914-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010186702
UNIVERA PROVIDER NUMBER
NY
01
—
000527029002
BLUE CROSS AND BLUE SHIEL
NY
01
—
0408452
IHA PROVIDER NUMBER
NY
01
—
2590704
GHI PROVIDER NUMBER
NY
Enumeration date
03/10/2006
Last updated
07/08/2007
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