Storm, Etta L

Storm, Etta L is an individual health care provider with primary practice located at 3085 Southwestern Blvd Suite 104, Orchard Park NY 14127-1233. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Storm, Etta L can be contacted via phone (716) 674-1292.

Contact Information

Primary practice address
3085 Southwestern Blvd Suite 104 Orchard Park NY 14127-1233
Phone: (716) 674-1292
Fax: (716) 677-4314
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X F380276-1 New York

Profile Details

NPI number 1487762258
LBN Legal business name Storm, Etta L
Credentials NP IN PEDIATRICS
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Jul 8th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1487762258 NPPES
Other 9511811 INDEPENDENT HEALTH
Other 00026500201 INDEPENDENT HEALTH
Other 000560930001 INDEPENDENT HEALTH

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