| NPI | 1730077728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM JEFFERY Office Manager 716-301-2036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-10-07 |