Healthcare Provider Details

I. General information

NPI: 1790324069
Provider Name (Legal Business Name): TRINITY MEDICAL WNY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 PARK CLUB LN STE 100
WILLIAMSVILLE NY
14221-5270
US

IV. Provider business mailing address

144 GENESEE ST FL 3
BUFFALO NY
14203-1560
US

V. Phone/Fax

Practice location:
  • Phone: 716-204-1101
  • Fax: 716-204-8528
Mailing address:
  • Phone: 716-601-3690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: THOMAS CUMBO
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 716-204-1101