Healthcare Provider Details

I. General information

NPI: 1427266923
Provider Name (Legal Business Name): SUDESH KAPUR M. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 MAIN ST SUITE 120
BUFFALO NY
14214-2693
US

IV. Provider business mailing address

332 TROY DEL WAY
WILLIAMSVILLE NY
14221-3336
US

V. Phone/Fax

Practice location:
  • Phone: 716-838-3880
  • Fax:
Mailing address:
  • Phone: 716-631-3895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number143974-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: