Provider Demographics
NPI:1346337011
Name:ASPIRE OF WESTERN NEW YORK INC.
Entity Type:Organization
Organization Name:ASPIRE OF WESTERN NEW YORK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDSCHUMAKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:716-505-5564
Mailing Address - Street 1:2356 N FOREST RD
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1224
Mailing Address - Country:US
Mailing Address - Phone:716-505-5560
Mailing Address - Fax:716-894-0148
Practice Address - Street 1:7 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2523
Practice Address - Country:US
Practice Address - Phone:716-505-5630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00474924Medicaid
NY9009937OtherIHA
NY512062001OtherBLUE CROSS
NY00011235101OtherUNIVERA
NYCB9169OtherMEDICARE RAILROAD
NY512062001OtherBLUE CROSS