Healthcare Provider Details

I. General information

NPI: 1437359593
Provider Name (Legal Business Name): ROBERT JOSEPH BIJAK DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6254 BALSAM FIR CT
CLARENCE CENTER NY
14032-9150
US

IV. Provider business mailing address

6254 BALSAM FIR CT
CLARENCE CENTER NY
14032-9150
US

V. Phone/Fax

Practice location:
  • Phone: 716-741-2330
  • Fax:
Mailing address:
  • Phone: 716-741-2330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN2731
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: