Individual
JEROME SHITTEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3495 BAILEY AVE, BUFFALO, NY 14215-1129
(716) 308-3576
Mailing address
116 CRANBURNE LANE, AMHERST, NY 14221-4971
(716) 308-3576
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
F430655-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
514256
NY
Other
Enumeration date
08/17/2008
Last updated
12/30/2016
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