Individual
MRS. MARY BETH EARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N. P.
Contact information
Practice address
325 ESSJAY RD, WILLIAMSVILLE, NY 14221-8243
(716) 630-1219
(716) 817-1726
Mailing address
425 ESSJAY RD, WILLIAMSVILLE, NY 14221-5782
(716) 630-1219
(716) 817-1726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F3306841
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0026512801
UNIVERA
NY
05
—
02674115
—
NY
01
—
5604161
COMM BLUE
NY
01
—
9511899
IHA
NY
Enumeration date
07/24/2006
Last updated
01/24/2018
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