Individual
MS. DIANA VIOLA MEDINA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ANP C
Contact information
Practice address
3775 SOUTHWESTERN BLVD, STE A, ORCHARD PARK, NY 14127
(716) 667-1980
(716) 667-1982
Mailing address
3775 SOUTHWESTERN BLVD, STE A, ORCHARD PARK, NY 14127
(716) 667-1980
(716) 667-1982
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F303935-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026761101
UNIVERA
NY
01
—
000560866001
BCBS
NY
01
—
147122CG
PREFERRED CARE
NY
01
—
9512629
INDEPENDENT HEALTH
NY
Enumeration date
08/24/2005
Last updated
07/08/2007
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