Healthcare Provider Details

I. General information

NPI: 1205186079
Provider Name (Legal Business Name): MASSOUD ARBABZADEH MD P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2012
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 WEHRLE DR STE 13
BUFFALO NY
14221-7385
US

IV. Provider business mailing address

365 RENAISSANCE DR
WILLIAMSVILLE NY
14221-2774
US

V. Phone/Fax

Practice location:
  • Phone: 716-859-4706
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: MRS. VALERIE V ALLEN
Title or Position: BILLING OFFICE MANAGER
Credential:
Phone: 585-417-6147