Individual
AYESHA DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
588 NORFOLK AVE, BUFFALO, NY 14215-2724
(716) 939-4471
Mailing address
588 NORFOLK AVE, BUFFALO, NY 14215-2724
(716) 939-4471
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
314890
NY
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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