Provider Demographics
NPI:1356489702
Name:SCHIFFHAUER, COLLEEN M (NP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:M
Last Name:SCHIFFHAUER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 IRVING TER
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-2739
Mailing Address - Country:US
Mailing Address - Phone:716-831-2200
Mailing Address - Fax:
Practice Address - Street 1:2697 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-1701
Practice Address - Country:US
Practice Address - Phone:716-831-2200
Practice Address - Fax:716-831-1065
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4205311363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000560619002OtherBLUE CROSS BLUE SHIELD
NY9512256ATNOtherIHA
NYRA0256Medicare ID - Type Unspecified
NY000560619002OtherBLUE CROSS BLUE SHIELD
NY9512256ATNOtherIHA