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General NPI Number Information
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NPI Number | 1841543808
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Entity Type | Individual
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Provider Name | LIOUDMILA PLISS
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Gender | Female
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 6631 MAIN ST STE 2
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5934
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Country | US
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Telephone | 716-428-5505
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Fax | 716-707-3935
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Provider Business Mailing Address
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Address Line | 6631 MAIN ST STE 2
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5934
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Country | US
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Telephone | 716-428-5505
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Fax | 716-428-5506
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | F306218-1
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License Number State | NY
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