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General NPI Number Information
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NPI Number | 1093958704
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Entity Type | Individual
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Provider Name | EVGENY ARKADYEVICH DYSKIN MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2009
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 462 GRIDER ST MAIL STOP 51103H
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City | BUFFALO
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State | NY
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Zip | 14215-3021
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Country | US
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Telephone | 716-898-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 4225 GENESEE ST
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City | CHEEKTOWAGA
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State | NY
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Zip | 14225-1994
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Country | US
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Telephone | 716-306-5927
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 58927
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | 58927
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License Number State | MN
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