| NPI | 1609065390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA SUSAN BRODSKY Director 716-362-9730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 276298) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008898-1) |
| 363A00000X Physician Assistant (Licence: NY 010010-1) | |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2008-06-27 |