Healthcare Provider Details
I. General information
NPI: 1588749816
Provider Name (Legal Business Name): MICHAEL A VASQUEZ, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/26/2006
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4927 MAIN ST STE 400
AMHERST NY
14226-4081
US
IV. Provider business mailing address
4927 MAIN ST STE 400
AMHERST NY
14226-4081
US
V. Phone/Fax
- Phone: 716-877-7000
- Fax: 716-322-1164
- Phone: 716-877-7000
- Fax: 716-322-1164
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | 198880 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
MICHAEL
ANTHONY
VASQUEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 716-690-2691