Basic Information
| Provider Information | |||||||||
| NPI: | 1164489043 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERBERGER | ||||||||
| FirstName: | CINDY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2697 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142141701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168312200 | ||||||||
| FaxNumber: | 5854547001 | ||||||||
| Practice Location | |||||||||
| Address1: | 2697 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142141701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168312200 | ||||||||
| FaxNumber: | 5854547001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 12/16/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | 420673 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | 000560839002 | 01 | NY | BLUE CROSS, MS | OTHER | 000560839001 | 01 | NY | BLUE CROSS, WS | OTHER | 9512285 | 01 | NY | INDEPENDENT HEALTH | OTHER |