Healthcare Provider Details

I. General information

NPI: 1366407173
Provider Name (Legal Business Name): RANJAN BHAYANA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 MAIN ST SUITE 2
WILLIAMSVILLE NY
14221-5800
US

IV. Provider business mailing address

6255 SHERIDAN DR SUITE 304
WILLIAMSVILLE NY
14221-4836
US

V. Phone/Fax

Practice location:
  • Phone: 716-630-1164
  • Fax: 716-630-2608
Mailing address:
  • Phone: 716-857-8666
  • Fax: 716-857-8944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number192011-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: