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General NPI Number Information
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NPI Number | 1740922210
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Entity Type | Individual
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Provider Name | CHELSEA RENEE MASICH NP
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Gender | Female
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 875 ELLICOTT ST
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City | BUFFALO
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State | NY
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Zip | 14203-1034
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Country | US
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Telephone | 716-748-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1012 HIGHLAND AVE
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City | TONAWANDA
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State | NY
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Zip | 14223-1835
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Country | US
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Telephone | 716-418-2264
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Fax |
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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 | F349204-01
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License Number State | NY
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