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General NPI Number Information
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NPI Number | 1215224365
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Entity Type | Organization
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Legal Business Name | INTEGRATED CLINICAL SERVICES
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 07/08/2011
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Provider Practice Location Address
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Address Line | 3085 HARLEM RD STE 350
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City | CHEEKTOWAGA
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State | NY
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Zip | 14225-2591
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Country | US
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Telephone | 716-844-5600
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Fax | 716-844-5750
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Provider Business Mailing Address
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Address Line | 3085 HARLEM RD STE 350
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City | CHEEKTOWAGA
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State | NY
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Zip | 14225-2591
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Country | US
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Telephone | 716-844-5600
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Fax | 716-844-5750
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Authorized Official
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Title or Position | CHAIRMAN AND PRESIDENT
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Name | DR. MICHAEL DUFF
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Credential | M.D.
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Telephone | 716-844-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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