Healthcare Provider Details

I. General information

NPI: 1285692939
Provider Name (Legal Business Name): AMHERST EAR NOSE & THROAT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 02/26/2020
Certification Date: 02/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6041 TRANSIT RD SUITE 101
E. AMHERST NY
14051
US

IV. Provider business mailing address

6041 TRANSIT RD SUITE 101
E. AMHERST NY
14051
US

V. Phone/Fax

Practice location:
  • Phone: 716-691-3500
  • Fax: 716-691-3548
Mailing address:
  • Phone: 716-691-3500
  • Fax: 716-691-3548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGG ZIMMER
Title or Position: BUSINESS OWNER
Credential: M.D.
Phone: 716-691-3500