Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 70011700 | NY |
Y | 111NR0200X | Radiology | 70011700 | NY |
Y | 213ER0200X | Radiology | 70011700 | NY |
NPI | 1700211240 |
---|---|
Provider Name | Dr. Stephanie Elaine Mussmann |
First Address | Buffalo, NY 14201-1032 |
Second Address | Buffalo, NY 14214-1718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2013 |
Last Update Date | 03/09/2013 |