Graham Joshua Anderson, CRPA-P4479
Individual provider Active NPI Peer Specialist · Buffalo, NY
NPI 1053924522 · NPPES record last updated Aug 25, 2020
Key facts
- NPI
- 1053924522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- CRPA-P-4470 (NY)
- Practice address
- 64 Linwood Ave.
Buffalo, NY 14209 - Phone
- (716) 424-4211
- Fax
- (716) 884-4211
- NPI assigned
- Aug 25, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CRPA-P-4470 | NY | MD | Peer Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | CRPA-P-4470 | NY | Yes |
Addresses
Primary practice location
64 Linwood Ave.
Buffalo, NY 14209
Mailing address
64 Linwood Ave.
Buffalo, NY 14209
Phone (716) 424-4211
Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.