Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | F3008701 | NY |
NPI | 1003809864 |
---|---|
Provider Name | Mrs. Diane Stonemetz |
First Address | West Seneca, NY 14224 |
Second Address | West Seneca, NY 14224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 17/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02343873 | (05) | NY |