Individual
NICHOLAS JOHN MIRUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEER ADVOCATE
Contact information
Practice address
430 NIAGARA ST, BUFFALO, NY 14201-1886
(716) 856-2587
Mailing address
430 NIAGARA ST, BUFFALO, NY 14201-1886
(716) 856-2587
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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