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Individual

LYDIA MARIE WISHMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
665 ELM ST, BUFFALO, NY 14203-1104
(716) 341-5504
Mailing address
ELM AND CARLTON ST, BUFFALO, NY 14263-0001

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
312201-01
NY
363LG0600X
Gerontology Nurse Practitioner
Primary
312201-01
NY

Other

Enumeration date
12/18/2025
Last updated
12/18/2025
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