Individual
MARIE MASTRANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3675 SOUTHWESTERN BLVD, ORCHARD PARK, NY 14127-1732
(716) 972-0279
Mailing address
3675 SOUTHWESTERN BLVD, ORCHARD PARK, NY 14127-1732
(716) 972-0279
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310686
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310686
NYS LICENSE
NY
Enumeration date
02/11/2022
Last updated
02/11/2022
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