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General NPI Number Information
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NPI Number | 1194876300
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Entity Type | Organization
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Legal Business Name | MAIN BUFFALO PEDIATRICS LLP
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 02/26/2016
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Provider Practice Location Address
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Address Line | 2924 MAIN ST
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City | BUFFALO
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State | NY
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Zip | 14214-1706
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Country | US
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Telephone | 716-837-0995
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Fax | 716-837-1203
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Provider Business Mailing Address
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Address Line | 2924 MAIN ST
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City | BUFFALO
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State | NY
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Zip | 14214-1706
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Country | US
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Telephone | 716-837-0995
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Fax | 716-837-1203
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. EMILY S FRIEDAN
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Credential | MD
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Telephone | 716-837-0995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 169949-1
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License Number State | NY
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