Healthcare Provider Details

I. General information

NPI: 1588735203
Provider Name (Legal Business Name): ALBERT JOSE DIAZ-ORDAZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 STERLING DR STE 105
ORCHARD PARK NY
14127-1500
US

IV. Provider business mailing address

199 PARK CLUB LN STE 500
WILLIAMSVILLE NY
14221-5269
US

V. Phone/Fax

Practice location:
  • Phone: 716-677-9220
  • Fax: 716-677-9226
Mailing address:
  • Phone: 716-845-1300
  • Fax: 716-322-3372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number162503
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: