Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 002173-1 | NY |
NPI | 1225130750 |
---|---|
Provider Name | Mrs. Donna Sullivan Niswander |
First Address | Buffalo, NY 14214-1610 |
Second Address | Buffalo, NY 14203-1514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2006 |
Last Update Date | 08/07/2007 |