Individual
DR. JENNA CHRISTINE VAN DUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
6950 S TRANSIT RD, LOCKPORT, NY 14094-6333
(716) 656-4588
(716) 817-1781
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-8235
(716) 630-1219
(716) 817-1726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
325964
NY
207Q00000X
Family Medicine Physician
OS020806
PA
207Q00000X
Family Medicine Physician
OT019552
PA
Other
Enumeration date
07/03/2019
Last updated
11/25/2024
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