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General NPI Number Information
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NPI Number | 1285975540
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Entity Type | Organization
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Legal Business Name | BUFFALO GASTROENTEROLOGY ASSOCIATES, LLP
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 260 RED TAIL LN
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1562
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Country | US
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Telephone | 716-677-6501
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Fax |
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Provider Business Mailing Address
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Address Line | 260 RED TAIL LN
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1562
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Country | US
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Telephone | 716-677-6501
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR
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Name | DR. KEVIN ROBILLARD
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Credential |
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Telephone | 716-677-6509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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