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General NPI Number Information
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NPI Number | 1356591051
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Entity Type | Organization
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Legal Business Name | CANGE FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 09/30/2008
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Last Update Date | 09/30/2008
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Provider Practice Location Address
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Address Line | 8770 TRANSIT RD
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City | EAST AMHERST
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State | NY
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Zip | 14051-1840
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Country | US
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Telephone | 716-639-7690
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Fax | 716-639-3716
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Provider Business Mailing Address
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Address Line | 8770 TRANSIT RD
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City | EAST AMHERST
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State | NY
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Zip | 14051-1840
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Country | US
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Telephone | 716-639-7690
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Fax | 716-639-3716
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEAN-MARCAISSE CANGE
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Credential | MD
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Telephone | 716-639-7690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 196062
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License Number State | NY
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