Provider Demographics
NPI:1902893860
Name:BRITTON, ELISABETH M (MD)
Entity type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:M
Last Name:BRITTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1560
Mailing Address - Country:US
Mailing Address - Phone:716-601-3701
Mailing Address - Fax:716-447-6793
Practice Address - Street 1:397 LOUISIANA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14204-2275
Practice Address - Country:US
Practice Address - Phone:716-847-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME016608207Q00000X
NY316640207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME010460405OtherINDIVIDUAL BILLING NUMBER
NY07903900Medicaid
WI1902893860Medicaid
MEI21658Medicare UPIN
MEME1048Medicare ID - Type UnspecifiedINDIVIDUAL BILLING NUMBER