Healthcare Provider Details

I. General information

NPI: 1811886690
Provider Name (Legal Business Name): NORTHTOWNS NEUROSURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2025
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MICHIGAN AVE STE 210
BUFFALO NY
14203-1538
US

IV. Provider business mailing address

700 MICHIGAN AVE STE 210
BUFFALO NY
14203-1538
US

V. Phone/Fax

Practice location:
  • Phone: 716-219-5515
  • Fax: 716-217-6380
Mailing address:
  • Phone: 716-219-5515
  • Fax: 716-217-6380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH A SHEHADI
Title or Position: OWNER
Credential: MD
Phone: 614-565-3958