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NPI Code Detail

MEDICARE: MYRON R SIEGEL MD

MEDICARE:   MYRON R SIEGEL  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
12080A0000XPediatric Adolescent Medicine Physician141858NY

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 : 1568467090
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRON R SIEGEL MD
Provider Business Mailing Address
First Line : 94 OLEAN ST
Second Line : STE 210
City : EAST AURORA
State : NY
Zip : 14052-2531
Country : US
Telephone Number : 716-652-0237
Fax Number : 716-652-0983
Provider Business Practice Location Address
First Line : 94 OLEAN ST
Second Line : STE 210
City : EAST AURORA
State : NY
Zip : 14052-2531
Country : US
Telephone Number : 716-652-0237
Fax Number : 716-652-0983
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 07/15/2010

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Directions to “ MYRON R SIEGEL MD” Practice Location

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