Provider Demographics
NPI:1053292193
Name:WILSON-MCDANIELS, LONNESHA (CRANIAL PROSTHESES)
Entity type:Individual
Prefix:
First Name:LONNESHA
Middle Name:
Last Name:WILSON-MCDANIELS
Suffix:
Gender:F
Credentials:CRANIAL PROSTHESES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4498 MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3826
Mailing Address - Country:US
Mailing Address - Phone:716-703-1755
Mailing Address - Fax:
Practice Address - Street 1:2658 DELAWARE AVE STE 6
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-1147
Practice Address - Country:US
Practice Address - Phone:716-703-1755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management