Healthcare Provider Details

I. General information

NPI: 1588976096
Provider Name (Legal Business Name): NORTHTOWNS ORTHOPEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6133 ROUTE 219 S SUITE 1001
ELLICOTTVILLE NY
14731-9613
US

IV. Provider business mailing address

8750 TRANSIT RD SUITE 105
EAST AMHERST NY
14051-2610
US

V. Phone/Fax

Practice location:
  • Phone: 716-636-1470
  • Fax: 716-636-1423
Mailing address:
  • Phone: 716-636-1470
  • Fax: 716-636-1423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. DONALD P DOUGLAS
Title or Position: M.D./MANAGING PARTNER
Credential: M.D.
Phone: 716-636-1470