Healthcare Provider Details

I. General information

NPI: 1538199864
Provider Name (Legal Business Name): SPINE SURGERY OF BUFFALO NIAGARA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6941 WILLIAMS RD
NIAGARA FALLS NY
14304
US

IV. Provider business mailing address

6941 WILLIAMS RD
NIAGARA FALLS NY
14304-3022
US

V. Phone/Fax

Practice location:
  • Phone: 716-629-3338
  • Fax: 716-304-6571
Mailing address:
  • Phone: 716-629-3338
  • Fax: 716-304-6571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANCO E VIGNA
Title or Position: OWNER
Credential: MD
Phone: 716-629-3338