National Provider Identifier
Mary Beth Moore, AGNP-C
Mary Beth Moore, AGNP-C is listed in the NPPES registry with a primary specialty of Registered Nurse in Buffalo, NY and a listed phone number of (716) 995-4450.
Profile Overview
- NPI
- 1386886299
- Provider Type
- Individual
- Primary Specialty
- Registered Nurse
- Enumeration Date
- March 25, 2009
- Last Updated
- October 24, 2019
Practice Location
- 701 Seneca St Ste 646C
- Buffalo, NY 14210-1351
Phone: (716) 995-4450
Mailing Address
- 100 College Pkwy
- Ste 260
- Williamsville, NY 14221-6800
Specialties
- Registered Nurse (163W00000X)
- Adult Health Nurse Practitioner (363LA2200X)
Full Record
- NPI
- 1386886299
- Entity Type
- Individual
- Last Name
- Moore
- First Name
- Mary Beth
- Name Prefix
- Mrs.
- Credential
- AGNP-C
- Provider Other Last Name
- Reilly
- Provider Other First Name
- Mary Beth
- Provider Other Credential Text
- BSN, RN
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 100 College Pkwy
- Mailing Address Line 2
- Ste 260
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-6800
- Mailing Country
- US
- Mailing Phone
- (716) 868-2252
- Practice Street Address
- 701 Seneca St Ste 646C
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14210-1351
- Practice Country
- US
- Practice Phone
- (716) 995-4450
- Enumeration Date
- March 25, 2009
- Last Updated
- October 24, 2019
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Nurse (163W00000X), Adult Health Nurse Practitioner (363LA2200X)
- Other Identifiers
- 1386886299 (NY, NPI)