National Provider Identifier
Marie Lynn Pettitt
Marie Lynn Pettitt is listed in the NPPES registry with a primary specialty of Athletic Trainer in Tonawanda, NY and a listed phone number of (716) 957-2674.
Profile Overview
- NPI
- 1558964056
- Provider Type
- Individual
- Primary Specialty
- Athletic Trainer
- Enumeration Date
- November 17, 2020
- Last Updated
- January 22, 2025
Practice Location
- 355 Adam St
- Tonawanda, NY 14150-1903
Phone: (716) 957-2674
Mailing Address
- 111 N Maplemere RD
- Buffalo, NY 14221-3181
Specialties
- Athletic Trainer (2255A2300X)
Endpoints
- mariepet@buffalo.edu
Connect Url | Tonawanda, NY 14150
Full Record
- NPI
- 1558964056
- Entity Type
- Individual
- Last Name
- Pettitt
- First Name
- Marie
- Middle Name
- Lynn
- Mailing Street Address
- 111 N Maplemere RD
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14221-3181
- Mailing Country
- US
- Mailing Phone
- (716) 957-2674
- Practice Street Address
- 355 Adam St
- Practice City
- Tonawanda
- Practice State
- NY
- Practice ZIP Code
- 14150-1903
- Practice Country
- US
- Practice Phone
- (716) 957-2674
- Enumeration Date
- November 17, 2020
- Last Updated
- January 22, 2025
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- January 22, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Athletic Trainer (2255A2300X)