Individual
MARYELLEN LUCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
255 DELAWARE AVE FL 4, BUFFALO, NY 14202-2016
(716) 842-0440
Mailing address
255 DELAWARE AVE FL 4, BUFFALO, NY 14202-2016
(716) 842-0440
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
621275
NY
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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