Individual
MRS. ASHLEY ANN PROVENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
462 GRIDER ST, SUITE 15, BUFFALO, NY 14215-3021
(716) 898-3152
Mailing address
160 CARDINAL LN, GRAND ISLAND, NY 14072-1988
(585) 317-9546
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
339765
NY
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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