MR. JERRY L CORP II (NPI# 1003261322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003261322 |
| Entity Type | Individual |
| Full Name | MR. JERRY L CORP II |
| Credential | PMHNP-BC |
| Practice Address |
255 Delaware Ave Buffalo NY 14202-2016 |
| Practice Telephone | 7168840888 |
| Mailing Telephone | 7168840888 |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2020-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
402647 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
255 DELAWARE AVE |
| City | BUFFALO |
| State | NY |
| Zip Code | 14202-2016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508868407 | Bestself Behavioral Health, Inc. | Counselor | 255 Delaware Ave, Buffalo, NY 14202-2016 | 2005-08-11 |
| 1184239816 | Mqdad Bayz | Peer Specialist | 255 Delaware Ave, Buffalo, NY 14202-2016 | 2020-09-10 |
| 1477170942 | Faith Nicole White | Registered Nurse | 255 Delaware Ave, Buffalo, NY 14202-2016 | 2020-07-01 |
| 1063958064 | Mary Logan | Counselor | 255 Delaware Ave, Suite 300, Buffalo, NY 14202-2016 | 2017-01-13 |
| 1538535695 | Madelyn Henry | Nurse Practitioner | 255 Delaware Ave, Suite 300, Buffalo, NY 14202-2016 | 2015-08-12 |
| 1326465717 | Marguerite Astyk | Registered Nurse | 255 Delaware Ave, Suite 300, Buffalo, NY 14202-2016 | 2014-03-24 |
| 1306272620 | Adele Schmidt | Counselor | 255 Delaware Ave, Buffalo, NY 14202 | 2013-09-18 |
| 1629389309 | Jill A Lewis | Social Worker | 255 Delaware Ave, Suite 300, Buffalo, NY 14202-2016 | 2010-06-28 |
| 1487973426 | Lake Shore Behavioral Health | Community/Behavioral Health | 255 Delaware Ave, Suite 300, Buffalo, NY 14202-2016 | 2010-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376141655 | Deborah Elaine Ricci | Counselor | 43o Niagara Sq, Buffalo, NY 14202 | 2020-10-09 |
| 1831716208 | Meagan Licata | Counselor | Bestself Behavioral Health, 255 Delaware Ave Ste 300, Buffalo, NY 14202 | 2020-07-01 |
| 1962022483 | Autumn Marie Hayes I | Counselor | 625 Deleware Avenue, Suite 204, Buffalo, NY 14202 | 2020-04-24 |
| 1861012742 | Natasha Qutab | Student in an Organized Health Care Education/Training Program | Department of Neurology, 1010 Main Street, 2nd Floor, Buffalo, NY 14202 | 2020-04-21 |
| 1396232245 | Wood Dental LLC | Dentist | 564 Franklin Street, Buffalo, NY 14202 | 2018-04-17 |
| 1083130728 | Lydia Heeeun Doublestein | Advanced Practice Midwife | 367 Delaware Ave, Buffalo, NY 14202 | 2017-08-15 |
| 1356861652 | Michelle Cheesman | Speech-Language Pathologist | 801 City Hall, Buffalo, NY 14202 | 2017-06-27 |
| 1275082075 | Tempresst Nycole Batts Ravenell | Registered Nurse | 69 Delaware Ave Suite 1200, Interim Healthcare, Buffalo, NY 14202 | 2016-09-22 |
| 1972974764 | Tiffany Tyran | Registered Nurse | 69 Delaware Ave, Suite 1200, Buffalo, NY 14202 | 2015-10-19 |
| 1487044368 | Katherine Jeffries-coppola | Registered Nurse | 69 Delaware Ave. Suite 1200, Buffalo, NY 14202 | 2015-01-29 |
| Find all providers in zip 14202 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780284869 | Mary Gwynne Tillotson | Nurse Practitioner | 82 Oxford Ave, Buffalo, NY 14209-1406 | 2020-10-28 |
| 1376140277 | Megan Elizabeth Bhatti | Nurse Practitioner | 2104 Delaware Ave Apt 1, Buffalo, NY 14216-3216 | 2020-10-04 |
| 1578176160 | Rachelle Camelle De La Cruz | Nurse Practitioner | 255 Delaware Ave Ste 400, Buffalo, NY 14202-2016 | 2020-08-25 |
| 1265054894 | James E Koch | Nurse Practitioner | 701 Seneca St Ste 416, Buffalo, NY 14210-1351 | 2020-05-18 |
| 1881078004 | Pamela Anne Almeter | Nurse Practitioner | 462 Grider St Rm 1168, Buffalo, NY 14215-3021 | 2015-07-17 |
| 1326421702 | Shirley Frieh | Nurse Practitioner | University At Buffalo Counseling Services, 120 Richmond Quad, Buffalo, NY 14261-0001 | 2015-07-03 |
| 1407146558 | Natasha C Pearson | Nurse Practitioner | 325 Cornwall Ave, Buffalo, NY 14215-3101 | 2011-04-11 |
| 1831419001 | Suzanne Marie Miller | Nurse Practitioner | 652 Delaware Ave, Suite 204, Buffalo, NY 14202 | 2010-06-10 |
| 1073163531 | Ehs, Inc. | Nurse Practitioner | 206 S Elmwood Ave, Buffalo, NY 14201-2398 | 2019-09-17 |
| 1013569979 | Alyssa Christine Weissinger | Nurse Practitioner | 1050 Niagara St, Buffalo, NY 14213-2001 | 2019-07-11 |
| Find all providers in BUFFALO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.