Healthcare Provider Details

I. General information

NPI: 1124069844
Provider Name (Legal Business Name): AURORA HOSPITALIST, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 ABBOTT RD @MERCY HOSPITAL OF BUFFALO
BUFFALO NY
14220-2039
US

IV. Provider business mailing address

400 CLIFTON CORPORATE PKWY SUITE 428
CLIFTON PARK NY
12065-3839
US

V. Phone/Fax

Practice location:
  • Phone: 518-383-5450
  • Fax: 518-383-4223
Mailing address:
  • Phone: 518-383-5450
  • Fax: 518-383-4223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN A BRACH
Title or Position: PRESIDENT, OWNER
Credential: MD
Phone: 518-383-5450