| Illumination Psychology Pllc | |
|
375 Linwood Ave Buffalo NY 14209-1663 | |
| (631) 209-7564 | |
| Not Available |
| Full Name | Illumination Psychology Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 375 Linwood Ave, Buffalo, New York |
| Authorized Official Name and Position | Michael Infranco (OWNER) |
| Authorized Official Contact | 6312097564 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illumination Psychology Pllc 375 Linwood Ave Buffalo NY 14209-1663 Ph: (631) 209-7564 | Illumination Psychology Pllc 375 Linwood Ave Buffalo NY 14209-1663 Ph: (631) 209-7564 |
| NPI Number | 1699384495 |
|---|---|
| Provider Enumeration Date | 07/28/2020 |
| Last Update Date | 09/18/2024 |
| Certification Date | 09/18/2024 |
| Medicare PECOS PAC ID | 7012337462 |
|---|---|
| Medicare Enrollment ID | O20201023000893 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699384495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Michael Joseph Infranco |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417436619 PECOS PAC ID: 4183052418 Enrollment ID: I20200319000907 |
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