Healthcare Provider Details

I. General information

NPI: 1528064136
Provider Name (Legal Business Name): JOHN CURTIS HELLRIEGEL JR. MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 11/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 LAWN AVE
BUFFALO NY
14207-1816
US

IV. Provider business mailing address

449 BRANTWOOD RD
AMHERST NY
14226-4641
US

V. Phone/Fax

Practice location:
  • Phone: 716-875-2904
  • Fax: 716-875-6717
Mailing address:
  • Phone: 716-838-3209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number137338
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: