Healthcare Provider Details

I. General information

NPI: 1497910855
Provider Name (Legal Business Name): ROSENDO I INTENGAN MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2008
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 DELAWARE AVE
BUFFALO NY
14209-2412
US

IV. Provider business mailing address

1275 DELAWARE AVE
BUFFALO NY
14209-2412
US

V. Phone/Fax

Practice location:
  • Phone: 716-882-2424
  • Fax:
Mailing address:
  • Phone: 716-882-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROSENDO I INTENGAN
Title or Position: OWNER
Credential: MD
Phone: 716-882-2424