Most Relevant Information
Provider Data
| NPI Number: | 1003029752 |
| Provider Name: | MARY LEE |
| Entity Type: | Individual |
| Taxonomy Code: | 156FX1800X |
| Specialty: | Technician/Technologist |
| License Number: | NY5166 |
Most Important Dates
| Enumeration Date: | 05/08/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
902 MAIN ST
BUFFALO
NY
142021403
Practice Location Phone/Fax
| Phone: | 7168839550 |
| Fax: |
Provider Mailing Location
366 EVERGREEN DR
TONAWANDA
NY
141506406
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |