Individual provider · Type 1 NPI

Mary Grace Distefano, RN ANP

Adult Health Nurse Practitioner · Depew, NY

NPI number 1710328968 Active

Practice location

3332 Walden Ave Ste 110
Depew, NY 14043-2400

Mailing address

28 Park Dr
Williamsville, NY 14221-6935

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200X306403 (NY)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1710328968

Mary Grace Distefano, RN ANP's National Provider Identifier is 1710328968, issued on Jul 16, 2013. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Depew, NY. The record was last updated on Jul 16, 2013.