Individual
WADZANAYI MOLIFE-PETHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
144 GENESEE ST, BUFFALO, NY 14203-1560
(716) 706-2112
Mailing address
144 GENESEE ST, BUFFALO, NY 14203-1560
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405043
NY
Other
Enumeration date
07/15/2024
Last updated
07/17/2024
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