Provider Demographics
NPI:1760732739
Name:WALDRAFF, DENISE M (RN, LPN)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:M
Last Name:WALDRAFF
Suffix:
Gender:F
Credentials:RN, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14206-1903
Mailing Address - Country:US
Mailing Address - Phone:716-895-1126
Mailing Address - Fax:
Practice Address - Street 1:170 FRANKLIN ST
Practice Address - Street 2:ALL METRO HEALTH CARE SUITE 205
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-2414
Practice Address - Country:US
Practice Address - Phone:716-856-2702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2013-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY514138-1163W00000X
NY233425-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY233425-1OtherTHE UNIVERSITY OF THE STATE OF NY ED. DEPT. OFFICE OF THE PROFESSIONS
NY514138-1OtherTHE UNIVERSITY OF THE STATE OF NY ED. DEPT. OFFICE OF THE PROFESSIONS