CELLACTIVE LLC NPI 1134030067

NPI Information

  • NPI: 1134030067
  • Provider Name: CELLACTIVE, LLC
  • Classification: Registered Nurse - 163WD0400X
  • Specialization: Diabetes Educator
  • Entity Type: Organization
  • Address: 779 BROAD ST STE 2
    SALAMANCA, NY
    ZIP 14779
  • Phone: (716) 271-1312

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NPI Details

CELLACTIVE, LLC is a diabetes educator registered nurse in Salamanca, NY. CELLACTIVE, LLC NPI is 1134030067. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

779 BROAD ST STE 2
SALAMANCA, NY
ZIP 14779-330
Phone: (716) 271-1312
Fax: (716) 271-1290

The provider's authorized official is Ross L John .
The authorized official title is Member and has the following contact phone number (716) 532-4466.

The enumeration date for this NPI number is 9/17/2026 and was last updated on 9/17/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WD0400XRegistered NurseDiabetes EducatorYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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