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General NPI Number Information
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NPI Number | 1255146726
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Entity Type | Organization
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Legal Business Name | THRIVE HEALTH WNY, PC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/23/2025
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Provider Practice Location Address
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Address Line | 301 CONNECTICUT ST
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City | BUFFALO
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State | NY
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Zip | 14213-2541
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Country | US
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Telephone | 716-923-4617
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Fax |
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Provider Business Mailing Address
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Address Line | 536 POTOMAC AVE
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City | BUFFALO
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State | NY
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Zip | 14222-1129
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Country | US
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Telephone | 716-535-6939
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID KHATIB
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Credential | DO
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Telephone | 716-923-4617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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