Most Relevant Information
Provider Data
| NPI Number: | 1003380528 |
| Provider Name: | JESSICA LYNN HAFEZI |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 343713 |
Most Important Dates
| Enumeration Date: | 01/17/2019 |
| Last Updated: | 01/14/2021 |
Provider Practice Location
ELM AND CARLTON STREETS
BUFFALO
NY
142630001
Practice Location Phone/Fax
| Phone: | 7168452300 |
| Fax: |
Provider Mailing Location
ELM AND CARLTON ST
BUFFALO
NY
142630001
Provider Mailing Phone/Fax
| Phone: | 7168452300 |
| Fax: |