Healthcare Provider Details

I. General information

NPI: 1588686307
Provider Name (Legal Business Name): JOAN M OSSWALD N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

397 LOUISIANA ST
BUFFALO NY
14204-2275
US

IV. Provider business mailing address

2875 UNION RD SUTIE 21
CHEEKTOWAGA NY
14227-1470
US

V. Phone/Fax

Practice location:
  • Phone: 716-847-6610
  • Fax: 716-854-3052
Mailing address:
  • Phone: 716-706-2034
  • Fax: 716-706-2035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number330889
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: