Healthcare Provider Details

I. General information

NPI: 1982659256
Provider Name (Legal Business Name): NIAGARA FALLS MEMORIAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 TENTH STREET
NIAGARA FALLS NY
14302
US

IV. Provider business mailing address

3719 UNION ROAD SUITE 218
CHEEKTOWAGA NY
14225
US

V. Phone/Fax

Practice location:
  • Phone: 716-278-4000
  • Fax:
Mailing address:
  • Phone: 716-651-0911
  • Fax: 716-651-9855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RAJESH MEHTA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 716-278-4399