Healthcare Provider Details

I. General information

NPI: 1821072281
Provider Name (Legal Business Name): HYPERBARIC MEDICINE & WOUND CARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 MILITARY RD
LEWISTON NY
14092-1903
US

IV. Provider business mailing address

5300 MILITARY RD
LEWISTON NY
14092-1903
US

V. Phone/Fax

Practice location:
  • Phone: 716-298-3012
  • Fax: 716-298-3016
Mailing address:
  • Phone: 716-298-3012
  • Fax: 716-298-3016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LEE C RUOTSI
Title or Position: DIRECTOR
Credential: MD
Phone: 716-298-3012