Healthcare Provider Details

I. General information

NPI: 1235391244
Provider Name (Legal Business Name): BRIAN D RAMBARRAN MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 SAUNDERS SETTLEMENT RD
SANBORN NY
14132-9128
US

IV. Provider business mailing address

3085 HARLEM RD SUITE 200
CHEEKTOWAGA NY
14225-2591
US

V. Phone/Fax

Practice location:
  • Phone: 716-898-2800
  • Fax: 716-898-2805
Mailing address:
  • Phone: 716-844-5600
  • Fax: 716-844-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number258163
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: