Individual
DEBRA HEVERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2315 WHIRLPOOL ST # 415, NIAGARA FALLS, NY 14305-2413
(210) 607-0126
Mailing address
2315 WHIRLPOOL ST # 415, NIAGARA FALLS, NY 14305-2413
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
129779
NY
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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