Individual
DARIYAUNA OVERTON-TABB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
625 DELAWARE AVE STE 150, BUFFALO, NY 14202-1000
(716) 884-1001
Mailing address
913 MARYVALE DR, CHEEKTOWAGA, NY 14225-2701
(716) 907-5175
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
337599
NY
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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