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NPI Code Detail

MEDICARE: DR. BRIAN BLOCK M.D.

MEDICARE: DR. BRIAN BLOCK M.D.
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
12085R0202XDiagnostic Radiology Physician114629NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528066214
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN BLOCK M.D.
Provider Business Mailing Address
First Line : 167 BRANDYWINE DR
Second Line :
City : WILLIAMSVILLE
State : NY
Zip : 14221-1876
Country : US
Telephone Number : 716-688-5725
Fax Number :
Provider Business Practice Location Address
First Line : 5300 MILITARY RD
Second Line : XRAY DEPT
City : LEWISTON
State : NY
Zip : 14092-1903
Country : US
Telephone Number : 716-298-2356
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/08/2007

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