Individual
MRS. ELIZABETH MARIE LOGALBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
256 MAIN ST, MASSENA, NY 13662-1901
(315) 764-1447
Mailing address
111 WALES AVE, TONAWANDA, NY 14150-2505
(716) 633-7600
(716) 633-7281
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
188335
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01332874
—
NY
Enumeration date
04/25/2006
Last updated
05/26/2017
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