Provider Demographics
NPI:1215164785
Name:HUFFMAN, VANESSA ELAINE (LMT)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:ELAINE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 EDWARD ST
Mailing Address - Street 2:3K
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14201-2130
Mailing Address - Country:US
Mailing Address - Phone:716-510-7781
Mailing Address - Fax:
Practice Address - Street 1:9424 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-2216
Practice Address - Country:US
Practice Address - Phone:716-568-2139
Practice Address - Fax:716-568-2106
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021628174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist