Provider Demographics
NPI:1366265639
Name:SMALL GENTLE HANDS LLC
Entity type:Organization
Organization Name:SMALL GENTLE HANDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICAL
Authorized Official - Prefix:
Authorized Official - First Name:JAQUITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-335-8761
Mailing Address - Street 1:505 ELLICOTT ST STE 305
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1547
Mailing Address - Country:US
Mailing Address - Phone:716-259-6954
Mailing Address - Fax:
Practice Address - Street 1:505 ELLICOTT ST STE 305
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1547
Practice Address - Country:US
Practice Address - Phone:716-259-6954
Practice Address - Fax:716-214-2053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty