Healthcare Provider Details

I. General information

NPI: 1720668114
Provider Name (Legal Business Name): AMAR TAKRANI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2021
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 BRECKENRIDGE ST
BUFFALO NY
14213-1562
US

IV. Provider business mailing address

182 BRECKENRIDGE ST
BUFFALO NY
14213-1562
US

V. Phone/Fax

Practice location:
  • Phone: 716-881-6191
  • Fax: 716-881-6247
Mailing address:
  • Phone: 716-881-6191
  • Fax: 716-881-6247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: