Healthcare Provider Details

I. General information

NPI: 1093088197
Provider Name (Legal Business Name): WESTERN NEW YORK PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N MAIN ST
WARSAW NY
14569-1025
US

IV. Provider business mailing address

2261 ROUTE 19 N
WARSAW NY
14569-9334
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-2290
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AHMED BAYOUMI
Title or Position: PARTNER
Credential: M.D.
Phone: 585-786-0681