National Provider Identifier
Dennis Michael Jack, FNP
Dennis Michael Jack, FNP is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Buffalo, NY and a listed phone number of (716) 609-0312.
Profile Overview
- NPI
- 1659858827
- Provider Type
- Individual
- Primary Specialty
- Family Nurse Practitioner
- Enumeration Date
- July 20, 2018
- Last Updated
- May 10, 2021
Practice Location
- 462 Grider St
- Buffalo, NY 14215-3021
Phone: (716) 609-0312
Mailing Address
- 6103 Woodford Dr
- Lake View, NY 14085-9457
Specialties
- Family Nurse Practitioner (363LF0000X)
Full Record
- NPI
- 1659858827
- Entity Type
- Individual
- Last Name
- Jack
- First Name
- Dennis
- Middle Name
- Michael
- Name Prefix
- Mr.
- Credential
- FNP
- Mailing Street Address
- 6103 Woodford Dr
- Mailing City
- Lake View
- Mailing State
- NY
- Mailing ZIP Code
- 14085-9457
- Mailing Country
- US
- Mailing Phone
- (716) 609-0312
- Practice Street Address
- 462 Grider St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14215-3021
- Practice Country
- US
- Practice Phone
- (716) 609-0312
- Enumeration Date
- July 20, 2018
- Last Updated
- May 10, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- May 10, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Nurse Practitioner (363LF0000X)