Individual
ANTHONY DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
462 GRIDER ST, BUFFALO, NY 14215-3021
(212) 810-9755
Mailing address
HOUSE NUMBER 416, BAMON BHATT, MERCES, GOA 40300-5
(212) 810-9755
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
340092
NY
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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