Individual
THERESA WYSOCHANSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
250 LINCOLN AVE, LOCKPORT, NY 14094-5531
(716) 471-7334
Mailing address
130 BEATTIE AVE, LOCKPORT, NY 14094-5023
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
754909
NY
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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