Provider Demographics
NPI:1629573076
Name:BRIMMER, DANA MARIE (DPM)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARIE
Last Name:BRIMMER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 HERTEL AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-2871
Mailing Address - Country:US
Mailing Address - Phone:716-897-3720
Mailing Address - Fax:949-561-4878
Practice Address - Street 1:1431 HERTEL AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-2871
Practice Address - Country:US
Practice Address - Phone:716-897-3720
Practice Address - Fax:949-561-4878
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007174-01213ES0103X
NY007174213ES0131X, 213EP1101X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06903539Medicaid
NY000551882002OtherBCBS
NY810933773Medicaid
NY220331000096OtherFIDELIS