Healthcare Provider Details

I. General information

NPI: 1578899126
Provider Name (Legal Business Name): LIBERTY COMMUNICATIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 11/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 KENMORE AVE
BUFFALO NY
14216-1135
US

IV. Provider business mailing address

1524 KENMORE AVE
BUFFALO NY
14216-1135
US

V. Phone/Fax

Practice location:
  • Phone: 716-877-7111
  • Fax: 716-874-1178
Mailing address:
  • Phone: 716-877-7111
  • Fax: 716-874-1178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number344600000X
License Number StateNY

VIII. Authorized Official

Name: MR. WILLIAM G YUHNKE
Title or Position: PRESIDENT
Credential:
Phone: 716-877-7111