Individual
ELENA MARIE WATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
263 FOREST CREEK LN, GRAND ISLAND, NY 14072-3507
(716) 868-7465
Mailing address
263 FOREST CREEK LN, GRAND ISLAND, NY 14072
(716) 868-7465
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
022533
NY
Other
Enumeration date
09/01/2018
Last updated
09/01/2018
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