Individual
MICHAEL SIMON MAISANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1901 SWEET HOME RD, AMHERST, NY 14228-5312
(716) 907-8242
Mailing address
81 MEADOW LEA DR, AMHERST, NY 14226-2830
(716) 907-8242
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001054-1
NY
Other
Enumeration date
11/23/2019
Last updated
11/23/2019
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