MARY GRACE DISTEFANO

DEPEW, NY
NPI1710328968
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: NY  306403)
Enumeration Date2013-07-16
Last Update Date2013-07-16
Business Address
-- MARY GRACE DISTEFANO RN ANP
3332 WALDEN AVE STE 110
DEPEW, NY 14043-2400
Phone number: 716-668-7051
Mailing Address
-- MARY GRACE DISTEFANO RN ANP
28 PARK DR
WILLIAMSVILLE, NY 14221-6935
Phone number: 716-949-1086
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