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General NPI Number Information
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NPI Number | 1114402922
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Entity Type | Organization
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Legal Business Name | BUFFALO SHORE MEDICAL PLLC
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Dates
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Enumeration Date | 09/27/2018
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Last Update Date | 09/27/2018
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Provider Practice Location Address
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Address Line | 3800 DELAWARE AVE
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City | KENMORE
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State | NY
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Zip | 14217-1094
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Country | US
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Telephone | 716-873-3828
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Fax | 716-873-5463
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Provider Business Mailing Address
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Address Line | 485 CAYUGA RD
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City | BUFFALO
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State | NY
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Zip | 14225-1368
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Country | US
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Telephone | 716-206-4590
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SATISH SHARMA
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Credential | MD
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Telephone | 716-206-4590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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