Most Relevant Information
Provider Data
| NPI Number: | 1003468190 |
| Provider Name: | CORY HERZOG DNP,CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 647231 |
Most Important Dates
| Enumeration Date: | 07/10/2019 |
| Last Updated: | 03/13/2024 |
Provider Practice Location
3495 BAILEY AVE
BUFFALO
NY
142151129
Practice Location Phone/Fax
| Phone: | 7168349200 |
| Fax: |
Provider Mailing Location
3495 BAILEY AVE
BUFFALO
NY
142151129
Provider Mailing Phone/Fax
| Phone: | 7168349200 |
| Fax: |