Individual
MRS. LUCILLE M. KINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
3580 SHERIDAN DR, AMHERST, NY 14226-1645
(716) 362-9730
(716) 362-9729
Mailing address
651 DELAWARE AVE, BUFFALO, NY 14202-1001
(716) 362-9730
(716) 362-9729
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
38046462
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02501586
—
NY
Enumeration date
03/15/2007
Last updated
07/08/2007
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