Provider Demographics
NPI:1386905115
Name:ASPIRE WNY
Entity type:Organization
Organization Name:ASPIRE WNY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEIT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABTH
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:KWIETNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-505-5700
Mailing Address - Street 1:4635 UNION RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1851
Mailing Address - Country:US
Mailing Address - Phone:716-505-5700
Mailing Address - Fax:716-633-9351
Practice Address - Street 1:4635 UNION RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-1851
Practice Address - Country:US
Practice Address - Phone:716-505-5700
Practice Address - Fax:716-633-9351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY781036252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency