Individual
MARY M DEVEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
ELM AND CARLTON STREETS, BUFFALO, NY 14263
(716) 845-2300
(716) 845-1668
Mailing address
ELM AND CARLTON ST, BUFFALO, NY 14263-0001
(716) 845-2300
(716) 845-1668
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F334409
NY
363LF0000X
Family Nurse Practitioner
F334409
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02960061
—
NY
Enumeration date
06/06/2007
Last updated
01/07/2021
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