Provider Demographics
NPI:1952665754
Name:WILBER, PATRICIA J
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:WILBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LEO MOSS DR
Mailing Address - Street 2:SUITE 4020
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1100
Mailing Address - Country:US
Mailing Address - Phone:716-373-8050
Mailing Address - Fax:716-701-3737
Practice Address - Street 1:1 LEO MOSS DR
Practice Address - Street 2:SUITE 4020
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1100
Practice Address - Country:US
Practice Address - Phone:716-373-8050
Practice Address - Fax:716-701-3737
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management