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Individual

BRENDA LIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
69 DELAWARE AVE, SUITE 1200, BUFFALO, NY 14202
(716) 852-5900
Mailing address
4373 CLINTON STREET, WEST SENECA, NY 14224

Taxonomy

Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
412294-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403392
NY

Other

Enumeration date
08/31/2016
Last updated
07/27/2023
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