National Provider Identifier
Mary Grace Distefano, RN ANP
Mary Grace Distefano, RN ANP is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner in Depew, NY and a listed phone number of (716) 668-7051.
Profile Overview
- NPI
- 1710328968
- Provider Type
- Individual
- Primary Specialty
- Adult Health Nurse Practitioner
- Enumeration Date
- July 16, 2013
- Last Updated
- July 16, 2013
Practice Location
- 3332 Walden Ave Ste 110
- Depew, NY 14043-2400
Phone: (716) 668-7051
Mailing Address
- 28 Park Dr
- Williamsville, NY 14221-6935
Specialties
- Adult Health Nurse Practitioner (363LA2200X)
Full Record
- NPI
- 1710328968
- Entity Type
- Individual
- Last Name
- Distefano
- First Name
- Mary
- Middle Name
- Grace
- Credential
- RN ANP
- Mailing Street Address
- 28 Park Dr
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-6935
- Mailing Country
- US
- Mailing Phone
- (716) 949-1086
- Practice Street Address
- 3332 Walden Ave Ste 110
- Practice City
- Depew
- Practice State
- NY
- Practice ZIP Code
- 14043-2400
- Practice Country
- US
- Practice Phone
- (716) 668-7051
- Enumeration Date
- July 16, 2013
- Last Updated
- July 16, 2013
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Adult Health Nurse Practitioner (363LA2200X)