Individual
STEPHANIE CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
183 FLORIDA ST # 2, BUFFALO, NY 14208-1213
(716) 886-6843
Mailing address
183 FLORIDA ST # 2, BUFFALO, NY 14208-1213
(716) 886-6843
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
402488020
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03980527
—
NY
Enumeration date
08/13/2018
Last updated
08/13/2018
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