Healthcare Provider Details

I. General information

NPI: 1578133427
Provider Name (Legal Business Name): VASANTHAN MUTHUSAMY KUMARASAMY MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 ELM STREET, ROSEWELL PARK COMPREHENSIVE CANCER CENT 8TH FLOOR, DEPT OF MEDICINE, P824, CSC BUILDING
BUFFALO NY
14203
US

IV. Provider business mailing address

665 ELM STREET, ROSEWELL PARK COMPREHENSIVE CANCER CENT 8TH FLOOR, DEPT OF MEDICINE, P824, CSC BUILDING
BUFFALO NY
14203
US

V. Phone/Fax

Practice location:
  • Phone: 716-845-2300
  • Fax: 716-862-1871
Mailing address:
  • Phone: 716-845-2300
  • Fax: 716-862-1871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number340752
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: