Healthcare Provider Details

I. General information

NPI: 1215515804
Provider Name (Legal Business Name): DALIA ISMAIL MBBCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 04/27/2025
Certification Date: 04/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 S CAYUGA RD
WILLIAMSVILLE NY
14221-6728
US

IV. Provider business mailing address

55 FOREST HILL DR
BUFFALO NY
14221-3216
US

V. Phone/Fax

Practice location:
  • Phone: 716-632-1088
  • Fax: 716-632-7842
Mailing address:
  • Phone: 706-449-6517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number334356
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: