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NPI Code Detail

MEDICARE: PULSE OCCUPATIONAL MEDICINE, PLLC

MEDICARE: PULSE OCCUPATIONAL MEDICINE, PLLC
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
12083X0100XOccupational Medicine Physician159276NY

General Provider Information

NPI Number : 1821119744
Entity Type Code : Organization
Provider Name (Legal Business Name) : PULSE OCCUPATIONAL MEDICINE, PLLC
Provider Business Mailing Address
First Line : PO BOX 1326
Second Line :
City : BUFFALO
State : NY
Zip : 14240-1326
Country : US
Telephone Number : 716-692-3302
Fax Number : 716-692-4342
Provider Business Practice Location Address
First Line : 7616 TRANSIT RD
Second Line :
City : WILLIAMSVILLE
State : NY
Zip : 14221-6017
Country : US
Telephone Number : 716-204-4500
Fax Number : 716-692-4342
Authorized Official
Title or Position : OWNER
Name : STEPHEN G HOLTZCLAW
Credential : MD
Telephone Number : 856-686-4317
Provider Enumeration Date : 04/02/2007
Last Update Date : 05/07/2012

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