Individual
MARY ELIZABETH WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
515 ABBOTT RD, STE 302, BUFFALO, NY 14220-1700
(716) 828-3520
(716) 828-3550
Mailing address
515 ABBOTT RD, STE 302, BUFFALO, NY 14220-1700
(716) 828-3520
(716) 828-3550
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
331111
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026546805
UNIVERA
NY
01
—
00026546806
UNIVERA
NY
01
—
000560180003
BLUE CROSS OF WNY
NY
01
—
000560180004
BLUE CROSS OF WNY
NY
01
—
051017000049
FIDELIS
NY
01
—
9512126
INDEPENDENT HEALTH
NY
01
—
P00287556
RAILROAD MEDICARE
NY
Enumeration date
07/26/2006
Last updated
07/08/2007
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