Individual
KARLA SHAW-AHISHAKIYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
699 HERTEL AVE STE 350, BUFFALO, NY 14207-2341
(716) 831-1977
Mailing address
55 DODGE RD, GETZVILLE, NY 14068-1205
(716) 831-2700
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
310828
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403170-01
NY
Other
Enumeration date
08/21/2012
Last updated
10/20/2020
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