Individual provider · Type 1 NPI

Lydia Marie Wishman

Gerontology Nurse Practitioner · Buffalo, NY

NPI number 1275498628 Active

Practice location

665 Elm St
Buffalo, NY 14203-1104

Mailing address

Elm And Carlton St
Buffalo, NY 14263-0001

Other practice locations

  • Elm And Carlton St, Buffalo, NY 14263-0001 · (716) 845-2300

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600X312201-01 (NY)
Nurse Practitioner 363L00000X312201-01 (NY)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1275498628

Lydia Marie Wishman's National Provider Identifier is 1275498628, issued on Dec 18, 2025. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Buffalo, NY. The record was last updated on Dec 18, 2025.