Healthcare Provider Details

I. General information

NPI: 1477606796
Provider Name (Legal Business Name): JOSEPH BRUCE NEIMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 YOUNGS RD
WILLIAMSVILLE NY
14221-8054
US

IV. Provider business mailing address

48 BRANDYWINE DR
WILLIAMSVILLE NY
14221-1804
US

V. Phone/Fax

Practice location:
  • Phone: 716-688-0020
  • Fax: 716-688-2328
Mailing address:
  • Phone: 716-688-5022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number117713
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: