Individual
MILDRED IYASERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
69 DELAWARE AVE, 1200, BUFFALO, NY 14202-3812
(716) 852-5900
Mailing address
1015 DELAWARE AVE, 404, BUFFALO, NY 14209-1651
(716) 361-3095
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
3166681
NY
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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