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NPI Code Detail

MEDICARE: THOM LOREE MD

MEDICARE: THOM LOREE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician156945NY

General Provider Information

NPI Number : 1215927330
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOM LOREE MD
Provider Business Mailing Address
First Line : 908 NIAGARA FALLS BLVD STE 208
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-2019
Country : US
Telephone Number : 716-692-3302
Fax Number : 166-924-3427
Provider Business Practice Location Address
First Line : 462 GRIDER ST
Second Line :
City : BUFFALO
State : NY
Zip : 14215-3098
Country : US
Telephone Number : 716-898-3073
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 07/05/2019

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