Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 340742 | NY |
NPI | 1003361585 |
---|---|
Provider Name | Stephanie Erin Myszka |
First Address | Lancaster, NY 14086-3227 |
Second Address | Buffalo, NY 14263-1200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2016 |
Last Update Date | 02/02/2021 |