Healthcare Provider Details

I. General information

NPI: 1215991351
Provider Name (Legal Business Name): QUAKER MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3560 N BUFFALO ST
ORCHARD PARK NY
14127-1934
US

IV. Provider business mailing address

3560 N BUFFALO ST
ORCHARD PARK NY
14127-1934
US

V. Phone/Fax

Practice location:
  • Phone: 716-662-8510
  • Fax: 716-662-8574
Mailing address:
  • Phone: 716-662-8510
  • Fax: 716-662-8574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCIS CHARLES MEZZADRI
Title or Position: M.D.
Credential: M.D.
Phone: 716-662-8510