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Individual

NANCY PROSPERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
462 GRIDER ST, BUFFALO, NY 14215-3021
(716) 898-3375
Mailing address
462 GRIDER ST, BUFFALO, NY 14215-3021
(716) 898-3375

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F332557
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00026530501
EXCELLUS UNIVERA
NY
05
01993695
NY
01
9512055
INDEPENDENT HEALTH
NY
Enumeration date
09/27/2006
Last updated
01/03/2008
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