Healthcare Provider Details

I. General information

NPI: 1508260704
Provider Name (Legal Business Name): UNITED MEMORIAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 NORTH ST SECOND FLOOR
BATAVIA NY
14020-1631
US

IV. Provider business mailing address

908 NIAGARA FALLS BLVD SUITE 208
NORTH TONAWANDA NY
14120-2019
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-5252
  • Fax: 585-344-7497
Mailing address:
  • Phone: 716-692-2160
  • Fax: 716-213-0935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CHIAVETTA
Title or Position: CFO/AUTHORIZED OFFICIAL
Credential:
Phone: 585-344-5439