Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 296907-1 | NY |
NPI | 1245650084 |
---|---|
Provider Name | Dr. Maria Grace Lennox |
First Address | Williamsville, NY 14221-8235 |
Second Address | Orchard Park, NY 14127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2014 |
Last Update Date | 22/05/2019 |