Healthcare Provider Details

I. General information

NPI: 1205754843
Provider Name (Legal Business Name): MARY JOE EID M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GOLISANO CHILDREN'S HOSPITAL OF BUFFALO 818 ELLICOTT STREET
BUFFALO NY
14203
US

IV. Provider business mailing address

AMERICAN UNIVERSITY OF BEIRUT MEDICAL CENTER RIAD EL-SOLH P.O. BOX 11-0236
BEIRUT LEBANON BEIRUT LEBANON
11072020
LB

V. Phone/Fax

Practice location:
  • Phone: 716-323-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberP141590
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: