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General NPI Number Information
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NPI Number | 1194771477
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY GROUP OF WESTERN NEW YORK PC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 05/04/2009
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Provider Practice Location Address
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Address Line | 825 WEHRLE DR
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7717
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Country | US
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Telephone | 716-634-3243
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Fax | 716-634-1930
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Provider Business Mailing Address
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Address Line | 825 WEHRLE DRIVE
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221
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Country | US
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Telephone | 716-634-3502
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Fax | 716-634-1930
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Authorized Official
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Title or Position | MEDICAL BILLER/CMC
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Name | MRS. MARILYN SCHULZ
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Credential |
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Telephone | 716-634-3502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 104448
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License Number State | NY
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