Healthcare Provider Details

I. General information

NPI: 1053339515
Provider Name (Legal Business Name): LINDA M HARRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGH ST DEPT OF SURGERY
BUFFALO NY
14203-1126
US

IV. Provider business mailing address

PO BOX 8000 DEPT 313 UNIVERSITY AT BUFFALO SURGEONS INC
BUFFALO NY
14267-0002
US

V. Phone/Fax

Practice location:
  • Phone: 716-859-4225
  • Fax: 716-859-4222
Mailing address:
  • Phone: 716-888-4889
  • Fax: 716-849-5620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number178098
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: