Individual
JESSICA M KOSTREWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6000 BROCKTON DR, LOCKPORT, NY 14094-9273
(716) 845-3400
(716) 438-1430
Mailing address
199 PARK CLUB LN STE 500, WILLIAMSVILLE, NY 14221-5269
(716) 845-1300
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F306893
NY
363LA2200X
Adult Health Nurse Practitioner
F306893
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04039149
—
NY
Enumeration date
09/22/2014
Last updated
10/09/2025
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