Healthcare Provider Details

I. General information

NPI: 1760475156
Provider Name (Legal Business Name): BARRY MICHAEL EPSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 MAIN ST
WILLIAMSVILLE NY
14221-5800
US

IV. Provider business mailing address

6333 MAIN ST
WILLIAMSVILLE NY
14221-5800
US

V. Phone/Fax

Practice location:
  • Phone: 716-632-3545
  • Fax: 716-632-6368
Mailing address:
  • Phone: 716-632-3545
  • Fax: 716-632-6368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number101589
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: