Provider Demographics
NPI:1598753824
Name:BRINKMAN, JANET CAROL (CCCA)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:CAROL
Last Name:BRINKMAN
Suffix:
Gender:F
Credentials:CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 S FOREST RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6425
Mailing Address - Country:US
Mailing Address - Phone:716-632-1884
Mailing Address - Fax:716-565-1837
Practice Address - Street 1:15 S FOREST RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6425
Practice Address - Country:US
Practice Address - Phone:716-632-1884
Practice Address - Fax:716-565-1837
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0011621231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01720401Medicaid
00011175701OtherUNIVERA
9290025OtherINDEPENDENT HEALTH
9290025OtherINDEPENDENT HEALTH