Provider Demographics
NPI:1962794271
Name:NOSWORTHY, ELENA
Entity type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:
Last Name:NOSWORTHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 BAILEY AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-2814
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 DELAWARE AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-3803
Practice Address - Country:US
Practice Address - Phone:716-845-2789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator