| NPI | 1053587519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA SIEGMAN Finance Manager 716-341-2411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363AM0700X Physician Assistant, Medical (Licence: NY 0087641) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 335055) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F3818411) | |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2025-04-01 |