Healthcare Provider Details
I. General information
NPI: 1518092923
Provider Name (Legal Business Name): CHRISTINE Z MOLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/23/2007
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 COLLEGE PKWY STE 220
WILLIAMSVILLE NY
14221-6800
US
IV. Provider business mailing address
100 COLLEGE PKWY STE 220
WILLIAMSVILLE NY
14221-6800
US
V. Phone/Fax
- Phone: 716-626-9019
- Fax: 716-626-9100
- Phone: 716-626-9019
- Fax: 716-626-9100
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 334733 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: