Provider Demographics
NPI:1437578119
Name:MANNIX, MARY KATHRYN (DO)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:MANNIX
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:8205 MAIN STREET
Mailing Address - Street 2:STE. 10
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-539-0789
Mailing Address - Fax:716-250-9090
Practice Address - Street 1:3950 E. ROBINSON RD
Practice Address - Street 2:STE. 205
Practice Address - City:WEST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228
Practice Address - Country:US
Practice Address - Phone:716-691-3400
Practice Address - Fax:716-691-3404
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2022-02-07
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Provider Licenses
StateLicense IDTaxonomies
NY288981208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics