Provider Demographics
NPI:1205481017
Name:ROBEL, RENEE (NP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:ROBEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:KRZYSTEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:93 HILL ST
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-3352
Mailing Address - Country:US
Mailing Address - Phone:716-998-2946
Mailing Address - Fax:
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-2342
Practice Address - Fax:716-859-3971
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344614363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY344614OtherNYS LICENSE - NP
NY706213OtherNYS LICENSE - RN