MEDICARE: DR. PATRICIA ANN MOWERY-RUSHTON PH.D

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	207SC0300X	Clinical Cytogenetics Physician	CQMOWEP1	NY

General Provider Information

NPI Number	:	1447443817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA ANN MOWERY-RUSHTON PH.D

Provider Business Mailing Address
First Line	:	55 AMHERST VILLA RD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14225-1400
Country	:	US
Telephone Number	:	716-710-7080
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 AMHERST VILLA RD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14225-1400
Country	:	US
Telephone Number	:	716-710-7080
Fax Number	:

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

Provider Enumeration Date	:	08/20/2007
Last Update Date	:	07/14/2023

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