Individual
MARY JO KISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4225 GENESEE ST, CHEEKTOWAGA, NY 14225-1994
(716) 906-5908
Mailing address
462 GRIDER ST, BUFFALO, NY 14215-3021
(716) 810-7999
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
307734
NY
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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