Individual
MRS. MARIETTA SCHRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
702 DAVISON RD, LOCKPORT, NY 14094-5371
(716) 514-9355
(716) 201-1630
Mailing address
32 GAFFNEY RD, LOCKPORT, NY 14094-5536
(716) 434-4957
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303221
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01000215
—
NY
Enumeration date
10/26/2006
Last updated
08/22/2013
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