Healthcare Provider Details

I. General information

NPI: 1225093057
Provider Name (Legal Business Name): LINDA MARIE STOCKMEYER P.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3560 N BUFFALO ST
ORCHARD PARK NY
14127-1934
US

IV. Provider business mailing address

3560 N BUFFALO ST
ORCHARD PARK NY
14127-1934
US

V. Phone/Fax

Practice location:
  • Phone: 716-662-8510
  • Fax: 716-662-8574
Mailing address:
  • Phone: 716-662-8510
  • Fax: 716-662-8574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number381248
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: