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General NPI Number Information
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NPI Number | 1538294608
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Entity Type | Individual
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Provider Name | THERESA MARIE BETZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3435 MAIN ST UNIVERSITY AT BUFFALO, MICHAEL HALL, STUDENT HEALTH
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City | BUFFALO
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State | NY
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Zip | 14214-3001
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Country | US
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Telephone | 716-829-3316
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Fax | 716-829-2364
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Provider Business Mailing Address
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Address Line | 17 ARLINGTON PL
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City | DEPEW
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State | NY
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Zip | 14043-1627
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Country | US
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Telephone | 716-684-9394
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Fax | 716-829-2364
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F331263
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License Number State | NY
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