Distefano, Mary Grace

Distefano, Mary Grace is an sole proprietor health care provider with primary practice located at 3332 Walden Ave Ste 110 , Depew NY 14043-2400. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Distefano, Mary Grace can be contacted via phone (716) 668-7051.

Contact Information

Primary practice address
3332 Walden Ave Ste 110 Depew NY 14043-2400
Phone: (716) 668-7051
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 306403 New York

Profile Details

NPI number 1710328968
LBN Legal business name Distefano, Mary Grace
Credentials RN ANP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 16th, 2013
Last updated Jul 16th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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