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General NPI Number Information
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NPI Number | 1043256506
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Entity Type | Organization
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Legal Business Name | BUFFALO PEDIATRIC ASSOCIATES LLP
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 217 LINWOOD AVE
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City | BUFFALO
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State | NY
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Zip | 14221
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Country | US
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Telephone | 716-637-0744
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Fax | 716-639-1954
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Provider Business Mailing Address
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Address Line | 217 LINWOOD AVE
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City | BUFFALO
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State | NY
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Zip | 14209
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Country | US
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Telephone | 716-884-8018
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Fax | 716-883-3203
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. JEAN M GUNNER
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Credential |
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Telephone | 716-884-4665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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