Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F301710-1 | NY |
NPI | 1023529831 |
---|---|
Provider Name | Mary Catherine Brown |
First Address | Buffalo, NY 14214-2726 |
Second Address | Buffalo, NY 14214-2726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2017 |
Last Update Date | 19/10/2017 |