Healthcare Provider Details
I. General information
NPI: 1629028089
Provider Name (Legal Business Name): NORTHTOWNS ORTHOPEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2006
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8750 TRANSIT RD SUITE 105
EAST AMHERST NY
14051-2610
US
IV. Provider business mailing address
8750 TRANSIT RD SUITE 105
EAST AMHERST NY
14051-2610
US
V. Phone/Fax
- Phone: 716-636-1470
- Fax: 716-636-1423
- Phone: 716-636-1470
- Fax: 716-636-1423
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOEL
FARWELL
Title or Position: PRACTICE MANAGER
Credential:
Phone: 716-636-1470