Healthcare Provider Details

I. General information

NPI: 1134270259
Provider Name (Legal Business Name): ARUMUGAM KUPERAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 ABBOTT RD
BUFFALO NY
14220-2049
US

IV. Provider business mailing address

805 ABBOTT RD
BUFFALO NY
14220-2049
US

V. Phone/Fax

Practice location:
  • Phone: 716-823-0888
  • Fax: 716-823-2237
Mailing address:
  • Phone: 716-823-0888
  • Fax: 716-823-2237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number139723
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: