Individual
MS. JEDIDAH DENISE DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1300 ELMWOOD AVE, BUFFALO, NY 14222-1004
(716) 878-6711
(716) 878-6727
Mailing address
1300 ELMWOOD AVE, BUFFALO, NY 14222-1004
(716) 878-6711
(716) 878-6727
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
302256
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302256
LIC
NY
Enumeration date
03/23/2007
Last updated
07/08/2007
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