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NPI Code Detail

MEDICARE: WHEATFIELD PEDIATRICS, LLP

MEDICARE: WHEATFIELD PEDIATRICS, LLP
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
1208000000XPediatrics Physician

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 : 1699753053
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHEATFIELD PEDIATRICS, LLP
Provider Business Mailing Address
First Line : 2890 NIAGARA FALLS BLVD
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-1114
Country : US
Telephone Number : 716-807-7337
Fax Number : 716-807-0848
Provider Business Practice Location Address
First Line : 2890 NIAGARA FALLS BLVD
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-1114
Country : US
Telephone Number : 716-807-7337
Fax Number : 716-807-0848
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. SARA B. DEVANTIER
Credential :
Telephone Number : 716-807-7337
Provider Enumeration Date : 01/05/2006
Last Update Date : 04/08/2025

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Directions to “WHEATFIELD PEDIATRICS, LLP ” Practice Location

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