MEDICARE: MARY PATRICIA WHISTLER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F333678	NY

General Provider Information

NPI Number	:	1265433759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY PATRICIA WHISTLER NP

Provider Business Mailing Address
First Line	:	539 CLEVELAND DR
Second Line	:
City	:	CHEEKTOWAGA
State	:	NY
Zip	:	14225-1080
Country	:	US
Telephone Number	:	716-834-9486
Fax Number	:	716-834-6466

Provider Business Practice Location Address
First Line	:	539 CLEVELAND DR
Second Line	:
City	:	CHEEKTOWAGA
State	:	NY
Zip	:	14225-1080
Country	:	US
Telephone Number	:	716-834-9486
Fax Number	:	716-834-6466

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	11/21/2007

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