Childpro of Western New York
NPI #1598974594 in Lackawanna, New York
Provider Information
- NPI Number
- 1598974594
- Entity Type
- Organization
- Organization Name
- Childpro of Western New York
- Primary Specialty
- Specialist
- Enumeration Date
- May 22, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1025 RIDGE RD
- City
- Lackawanna
- State
- New York
- ZIP Code
- 14218-1755
- Phone
- (716) 822-4781
Authorized Official
- Name
- MRS. MARY MAI IWANENKO, OTR
- Title
- CEO
- Phone
- (716) 822-4781
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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