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General NPI Number Information
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NPI Number | 1013263052
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Entity Type | Organization
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Legal Business Name | CCS MEDICAL, PLLC
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Dates
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Enumeration Date | 07/27/2012
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 45 SPINDRIFT DR SUITE 100
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7889
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Country | US
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Telephone | 716-565-0355
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Fax |
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Provider Business Mailing Address
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Address Line | 45 SPINDRIFT DR SUITE 100
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7889
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Country | US
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Telephone | 716-565-0355
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | WON SAM YI
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Credential | MD
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Telephone | 716-655-2690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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