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General NPI Number Information
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NPI Number | 1033227111
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Entity Type | Organization
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Legal Business Name | UPMC CHAUTAUQUA AT WCA
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 207 FOOTE AVE
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City | JAMESTOWN
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State | NY
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Zip | 14701-7077
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Country | US
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Telephone | 716-487-0141
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 840 207 FOOTE AVE.
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City | JAMESTOWN
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State | NY
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Zip | 14702-0840
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Country | US
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Telephone | 716-485-7892
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Fax | 716-487-1802
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Authorized Official
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Title or Position | CEO
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Name | BRIAN DURNIOK
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Credential |
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Telephone | 814-676-7146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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