MARY GRACE DISTEFANO (NPI# 1710328968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710328968 |
| Entity Type | Individual |
| Full Name | MARY GRACE DISTEFANO |
| Credential | RN ANP |
| Practice Address |
3332 Walden Ave Ste 110 Depew NY 14043-2400 |
| Mailing Address |
28 Park Dr Williamsville NY 14221-6935 |
| Practice Telephone | 7166687051 |
| Mailing Telephone | 7169491086 |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2013-07-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
306403 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3332 WALDEN AVE STE 110 |
| City | DEPEW |
| State | NY |
| Zip Code | 14043-2400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972825628 | Veronica Lee | Nurse Practitioner | 3332 Walden Ave Ste 110, Depew, NY 14043-2400 | 2010-02-23 |
| 1902462567 | Larika Evans | Nurse Practitioner | 3332 Walden Ave Ste 110, Depew, NY 14043-2400 | 2019-05-18 |
| 1457819682 | Veronica V Miles | Nurse Practitioner | 3332 Walden Ave Ste 110, Depew, NY 14043-2400 | 2019-03-06 |
| 1902306491 | Nicole Amanda Seitaj | Nurse Practitioner | 3332 Walden Ave Ste 110, Depew, NY 14043-2400 | 2018-02-20 |
| 1679091136 | Karen Marie Cisler | Nurse Practitioner | 3332 Walden Ave Ste 110, Depew, NY 14043 | 2017-09-05 |
| 1881939106 | Miles Dustin Sumner | Physician Assistant | 3332 Walden Ave Ste 110, Depew, NY 14043-2400 | 2012-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578117016 | Jennifer Wojcik | Specialist | 2049 George Urban Blvd., Depew, NY 14043 | 2019-08-01 |
| 1437628674 | Kelsey Marie Adams | Student in an Organized Health Care Education/Training Program | 171 Kokomo St. Apt 4, Depew, NY 14043 | 2018-11-16 |
| 1316425523 | Katherine Kolarczyk | Occupational Therapist | 2039 George Urban Boulevard, Depew, NY 14043 | 2018-07-31 |
| 1548786387 | Christina Sobieski | Specialist | 458 Dick Rd, Apt. B2, Depew, NY 14043 | 2017-08-14 |
| 1811418825 | Erin Kathleen Paone | Physician Assistant | 6337 Transit Rd, Depew, NY 14043 | 2017-06-29 |
| 1003350349 | Restoration Salon and Spa | Point of Service | 425 French Road, Depew, NY 14043 | 2016-12-06 |
| 1336525104 | Erica Janette Weber | Pharmacist | 236 Zurbrick Rd, Depew, NY 14043 | 2015-08-04 |
| 1205218781 | Ryan Edwin Knolhoff | Physical Therapy Assistant | 44 A Street, Depew, NY 14043 | 2015-06-22 |
| 1609297563 | Christine Lee Bartkowiak | Pharmacist | 4975 Transit Road, Depew, NY 14043 | 2013-12-19 |
| 1336499656 | Jennifer Warrington | Pharmacist | 124 Taylor Road, Depew, NY 14043 | 2012-09-13 |
| Find all providers in zip 14043 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972825628 | Veronica Lee | Nurse Practitioner | 3332 Walden Ave Ste 110, Depew, NY 14043-2400 | 2010-02-23 |
| 1245837442 | Katherine Mary Murphy | Nurse Practitioner | 571 Terrace Blvd, Depew, NY 14043-3610 | 2020-10-01 |
| 1457819682 | Veronica V Miles | Nurse Practitioner | 3332 Walden Ave Ste 110, Depew, NY 14043-2400 | 2019-03-06 |
| 1902306491 | Nicole Amanda Seitaj | Nurse Practitioner | 3332 Walden Ave Ste 110, Depew, NY 14043-2400 | 2018-02-20 |
| 1902344385 | Dilafruz Usman Elnasser | Nurse Practitioner | 3332 Walden Ave, Depew, NY 14043-2400 | 2017-02-06 |
| 1427493741 | Dawn Marie Sacks | Nurse Practitioner | 3332 Walden Ave, Suite 110, Depew, NY 14043-2400 | 2013-04-30 |
| 1689947426 | Nicole R Gannon | Nurse Practitioner | 3332 Walden Ave, Depew, NY 14043-2400 | 2012-02-09 |
| 1649542101 | Kirsten Foster Parker | Nurse Practitioner | 3332 Walden Ave, Depew, NY 14043-2400 | 2012-01-31 |
| 1386913242 | Mercedes Rivera-barber | Nurse Practitioner | 3332 Walden Ave, Suite 110, Depew, NY 14043-2400 | 2011-12-22 |
| 1780861922 | Suzanne Elizabeth Toland | Nurse Practitioner | 3332 Walden Ave, Ste 110, Depew, NY 14043-2400 | 2008-01-30 |
| Find all providers in DEPEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.