Healthcare Provider Details
I. General information
NPI: 1982792859
Provider Name (Legal Business Name): BUFFALO CARDIAC SURGICAL ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/10/2006
Last Update Date: 07/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 HIGH ST
BUFFALO NY
14203-1126
US
IV. Provider business mailing address
100 HIGH ST
BUFFALO NY
14203-1126
US
V. Phone/Fax
- Phone: 716-859-2243
- Fax: 716-859-2885
- Phone: 716-859-2243
- Fax: 716-859-2885
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
COLLEEN
MORRIS
Title or Position: BILLING MANAGER
Credential:
Phone: 716-859-3392