Individual
LARISSA BLENKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
71 LORRAINE AVE, BUFFALO, NY 14220-1740
(716) 816-4570
Mailing address
5160 WILLIAM ST, LANCASTER, NY 14086-9405
(716) 982-5835
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
659311
NY
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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