Individual
MS. JENNIFER LYNN SHOTWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
462 GRIDER ST, BUFFALO, NY 14215-3021
(716) 898-4040
Mailing address
266 BEDFORD AVE, BUFFALO, NY 14216-3104
(716) 574-4803
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
589674
NY
2471C3401X
Computed Tomography Radiologic Technologist
589674
NY
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
589674
NY
Other
Enumeration date
08/04/2017
Last updated
08/04/2017
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