Provider Demographics
NPI:1710521117
Name:VOIT, TRISHA MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:MICHELLE
Last Name:VOIT
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:TRISHA
Other - Middle Name:MICHELLE
Other - Last Name:DUDEREWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 BURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14210-2638
Mailing Address - Country:US
Mailing Address - Phone:716-587-1305
Mailing Address - Fax:
Practice Address - Street 1:2980 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-1918
Practice Address - Country:US
Practice Address - Phone:716-892-2060
Practice Address - Fax:716-892-0248
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist