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General NPI Number Information
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NPI Number | 1205054442
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Entity Type | Organization
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Legal Business Name | PODIATRY SOLUTIONS OF WNY
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 15 S FOREST RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6444
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Country | US
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Telephone | 716-634-5993
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Fax | 716-478-0946
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Provider Business Mailing Address
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Address Line | 15 S FOREST RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6444
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Country | US
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Telephone | 716-634-5993
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Fax | 716-478-0946
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON T WHITE
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Credential | DPM
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Telephone | 716-434-6601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 005864
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License Number State | NY
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