Provider Demographics
NPI:1164783460
Name:ADULT HEALTH NURSE PRACTITIONER ALL ABOUT YOU PRIMARY CARE PC
Entity Type:Organization
Organization Name:ADULT HEALTH NURSE PRACTITIONER ALL ABOUT YOU PRIMARY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NERFIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ELMINOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:716-341-7817
Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-3302
Mailing Address - Fax:
Practice Address - Street 1:2234 SENECA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14210-2438
Practice Address - Country:US
Practice Address - Phone:716-341-7817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty