Provider Demographics
NPI:1669464707
Name:MACISAAC, ANN MARIE H (NP)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:H
Last Name:MACISAAC
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:3140 SHERIDAN DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1900
Mailing Address - Country:US
Mailing Address - Phone:716-832-2920
Mailing Address - Fax:716-832-2956
Practice Address - Street 1:3140 SHERIDAN DR.
Practice Address - Street 2:SUITE 201
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-832-2920
Practice Address - Fax:716-832-2956
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2011-12-19
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Provider Licenses
StateLicense IDTaxonomies
NYF300539363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health