Healthcare Provider Details

I. General information

NPI: 1639179385
Provider Name (Legal Business Name): BARBARA Z. RADOLINSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 CENTER RD
WEST SENECA NY
14224-2218
US

IV. Provider business mailing address

888 CENTER RD
WEST SENECA NY
14224-2218
US

V. Phone/Fax

Practice location:
  • Phone: 716-675-7740
  • Fax:
Mailing address:
  • Phone: 716-675-7740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number148539
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: