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General NPI Number Information
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NPI Number | 1114185584
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Entity Type | Organization
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Legal Business Name | PEDRO G JOVEN MD PC
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Dates
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Enumeration Date | 06/01/2008
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 162 GEORGE URBAN BLVD
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City | CHEEKTOWAGA
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State | NY
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Zip | 14225-3004
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Country | US
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Telephone | 716-895-6826
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Fax | 716-895-1397
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Provider Business Mailing Address
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Address Line | 162 GEORGE URBAN BLVD
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City | CHEEKTOWAGA
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State | NY
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Zip | 14225-3004
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Country | US
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Telephone | 716-895-6826
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Fax | 716-895-1397
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Authorized Official
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Title or Position | MD
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Name | PEDRO G JOVEN
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Credential | MD
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Telephone | 716-895-6826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 104946
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License Number State | NY
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