Individual
SUSANNA JEAN ADDESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 STAHL RD, GETZVILLE, NY 14068-1231
(716) 629-3400
Mailing address
5 ELM PL, LANCASTER, NY 14086-2201
(716) 681-4046
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
361652-1
NY
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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