Healthcare Provider Details

I. General information

NPI: 1124212782
Provider Name (Legal Business Name): NIAGARA ORTHOPAEDICS ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 PARK PL
NIAGARA FALLS NY
14301-1028
US

IV. Provider business mailing address

700 PARK PL
NIAGARA FALLS NY
14301-1028
US

V. Phone/Fax

Practice location:
  • Phone: 716-285-7366
  • Fax:
Mailing address:
  • Phone: 716-285-7366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number143785
License Number StateNY

VIII. Authorized Official

Name: JOSEPH A BAX
Title or Position: DOCTOR/OWNER
Credential: MD
Phone: 716-285-7366