Maureen T Dallas, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

383033 Issued in NY

Practice address

2890 Niagara Falls Blvd
North Tonawanda, NY 14120-1114

Phone

(716) 807-7337

Fax

(716) 213-4400

NPI assigned

Jul 17, 2019

Last updated

Jul 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wheatfield Pediatrics, LLP

  • Pediatrics Physician
  • North Tonawanda, NY
  • NPI 1699753053
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1629621867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 NIAGARA FALLS BLVD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201114",
            "telephone_number": "716-807-7337",
            "fax_number": "716-213-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 NIAGARA FALLS BLVD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201114",
            "telephone_number": "716-807-7337",
            "fax_number": "716-213-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "MAUREEN",
        "middle_name": "T",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliet L Crossland Sorensen, DC
• Stephanie Rose Czaja
• Marnie Czarnecki, OTR
• Eric Paul Czora, OD
• Julie Ann Dadizio, MS,OTR/L
• Ronald T Daly Jr., DC
• Thomas Wade Danat Jr., PT, DPT
• Daniel Craigie
• Tracy M Dargan, RN
• Kelly Anne Darlak, PHARM.D, BCPS

• Pediatric Nurse Practitioner in North Tonawanda, NY
• Providers in North Tonawanda, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.