Healthcare Provider Details

I. General information

NPI: 1295869816
Provider Name (Legal Business Name): BRUCE L PLATT M.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 11/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 KENSINGTON AVE
BUFFALO NY
14215-1433
US

IV. Provider business mailing address

1616 KENSINGTON AVE
BUFFALO NY
14215-1433
US

V. Phone/Fax

Practice location:
  • Phone: 716-834-3278
  • Fax: 716-862-9342
Mailing address:
  • Phone: 716-834-3278
  • Fax: 716-862-9342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRUCE L PLATT
Title or Position: OWNER
Credential: M.D.
Phone: 716-834-3278