Most Relevant Information
Provider Data
| NPI Number: | 1003412255 |
| Provider Name: | DUSTIN JAMES LENZ-EMMI |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 774108 |
Most Important Dates
| Enumeration Date: | 12/11/2020 |
| Last Updated: | 12/11/2020 |
Provider Practice Location
790 GREEN MEADOW DR
MACEDON
NY
145028641
Practice Location Phone/Fax
| Phone: | 5852149018 |
| Fax: |
Provider Mailing Location
790 GREEN MEADOW DR
MACEDON
NY
145028641
Provider Mailing Phone/Fax
| Phone: | 5852149018 |
| Fax: |