Provider Demographics
NPI:1851987341
Name:BLUEBIRD TELESHRINK
Entity Type:Organization
Organization Name:BLUEBIRD TELESHRINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-698-7097
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-0206
Mailing Address - Country:US
Mailing Address - Phone:716-698-7097
Mailing Address - Fax:
Practice Address - Street 1:4087 TONAWANDA CREEK RD
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-9505
Practice Address - Country:US
Practice Address - Phone:716-698-7097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty