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Individual

MRS. DANIELLE LYNN VANDETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1120 YOUNGS ROAD, WILLIAMSVILLE, NY 14221
(716) 923-7326
(716) 677-5255
Mailing address
1120 YOUNGS ROAD, WILLIAMSVILLE, NY 14221
(716) 923-7326
(716) 677-5255

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
012683
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03061887
NY
Enumeration date
08/18/2008
Last updated
05/05/2015
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