Healthcare Provider Details

I. General information

NPI: 1265421564
Provider Name (Legal Business Name): SHALOM PRESS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 10/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 SWEET HOME RD
AMHERST NY
14228-2225
US

IV. Provider business mailing address

PO BOX 1096
AMHERST NY
14226-7096
US

V. Phone/Fax

Practice location:
  • Phone: 716-691-1414
  • Fax:
Mailing address:
  • Phone: 716-691-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number126644
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: