Individual
DEBORAH A. WYDYSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
1783 COLVIN BLVD, BUFFALO, NY 14223-1107
(716) 874-2150
(716) 874-6765
Mailing address
1783 COLVIN BLVD, BUFFALO, NY 14223-1107
(716) 693-2423
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
300587
NY
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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