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Individual

JAMES MOLLOSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4225 GENESEE ST, BUFFALO, NY 14225-1994
(716) 204-3200
Mailing address
4225 GENESEE ST, BUFFALO, NY 14225-1994
(716) 204-3200

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000064-1
NY
225700000X
Massage Therapist
028524
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000064-1
ATHLETIC TRAINER
NY
01
069702653
BOC
01
951618
NATA
Enumeration date
08/14/2020
Last updated
08/14/2020
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