Provider Demographics
NPI:1376193037
Name:MESI, MAURA (FNP)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:
Last Name:MESI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 ORCHARD PARK RD STE D
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1238
Mailing Address - Country:US
Mailing Address - Phone:716-671-8393
Mailing Address - Fax:716-671-8398
Practice Address - Street 1:3041 ORCHARD PARK RD STE D
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1238
Practice Address - Country:US
Practice Address - Phone:716-671-8393
Practice Address - Fax:716-671-8398
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345048363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily