Individual
MRS. SUSAN M BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
6760 MAIN ST, WILLIAMSVILLE, NY 14221-5947
(716) 626-0030
(716) 632-5356
Mailing address
6760 MAIN ST, WILLIAMSVILLE, NY 14221-5947
(716) 626-0030
(716) 632-5356
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006519
NY
Other
Enumeration date
09/29/2006
Last updated
09/07/2007
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