NPI 1003261322

Jerry L Corp, PMHNPBC

Practitioner Psychiatric/Mental Health Nurse Practitioner Buffalo, NY

Practice location

Address: 255 Delaware Ave, Buffalo, NY 14202-2016
Phone: (716) 884-0888

Registered specialties

Psychiatric/Mental Health Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LP0808X Licence 402647 (NY)

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Registry record

NPI: 1003261322
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Apr 2016
Record last updated: 7 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.