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Mary Grace Distefano, RNANP
Adult Health Nurse Practitioner in Depew, New York
NPI 1710328968

Mary Grace Distefano is an Adult Health Nurse Practitioner based in Williamsville, NY and is specialized in Adult Health. Mary Grace Distefano practices in Depew, NY and has the professional credentials of RNANP. The NPI Number for Mary Grace Distefano is 1710328968 and holds a License No. 306403 (New York).

The current practice location address for Mary Grace Distefano is 3332 Walden Ave Ste 110, Depew, NY and can be reached out via phone at 716-668-7051.

Location: 3332 Walden Ave Ste 110, Depew, NY, 14221-6935
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710328968
Provider Name
Mary Grace Distefano
Credential
RNANP
Provider Entity Type
Individual
Gender
Female
Address
3332 Walden Ave Ste 110, Depew, NY, 14221-6935
Phone Number
716-668-7051
Fax Number
Provider Enumeration Date
07/16/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3332 Walden Ave Ste 110
City
Depew
State
New York
Zip
14043-2400
Phone Number
716-668-7051
Fax Number
person
Provider Business Mailing Address Details
Address
3332 Walden Ave Ste 110
City
Depew
State
New York
Zip
14043-2400
Phone Number
716-668-7051
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
306403 (New York)
Definition
Definition to come...
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