| Western New York Integrated Care Collaborative, Inc. | |
|
742 Delaware Avenue, Buffalo, NY 14209 | |
| (716) 887-2749 | |
| Not Available |
| Full Name | Western New York Integrated Care Collaborative, Inc. |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 742 Delaware Avenue, Buffalo, New York |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881101954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133VN1006X | Dietitian, Registered - Nutrition, Metabolic | (* (Not Available)) | Secondary |
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | Maria Ines Aguero Demanunta |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1962858621 PECOS PAC ID: 9638466923 Enrollment ID: I20160930000671 |
| Mailing Address | Practice Location Address |
|---|---|
| Western New York Integrated Care Collaborative, Inc. 742 Delaware Avenue, Buffalo, NY 14209 Ph: (716) 887-2749 | Western New York Integrated Care Collaborative, Inc. 742 Delaware Avenue, Buffalo, NY 14209 Ph: (716) 887-2749 |
Stephanie Ann Lomas, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 462 Grider St, Buffalo, NY 14215 Phone: 716-898-3000 | |
Tara Lyn Cloutier, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 307 East St, Buffalo, NY 14207 Phone: 716-860-1731 | |
Ms. Barbara A Sylvester, RD, CDE Dietitian Medicare: Medicare Enrolled Practice Location: 3 Gates Cir, Buffalo, NY 14209 Phone: 716-887-5385 | |
Mrs. Lisa M. Bradt, RD, CSR, CDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 300 Delaware Ave, Suite 100, Buffalo, NY 14202 Phone: 716-903-3730 | |
Matthew Pellerite, RD Dietitian Medicare: Medicare Enrolled Practice Location: 300 Niagara St, Buffalo, NY 14201 Phone: 716-242-8600 Fax: 716-332-0832 | |
Perizat Adylbekova, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 11 Robin Rd, Buffalo, NY 14228 Phone: 716-320-0303 | |
Traci Punturiero, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 219 Bryant Street, Buffalo, NY 14222 Phone: 716-878-7893 |