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General NPI Number Information
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NPI Number | 1396170981
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Entity Type | Organization
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Legal Business Name | CLINICAL NEUROSCIENCE SERVICES MED/SURG PLLC
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Dates
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Enumeration Date | 09/13/2013
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Last Update Date | 09/13/2013
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Provider Practice Location Address
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Address Line | 4050 HARLEM RD
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City | AMHERST
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State | NY
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Zip | 14226-4711
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Country | US
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Telephone | 716-803-1507
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Fax | 716-803-1508
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Provider Business Mailing Address
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Address Line | 4050 HARLEM RD
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City | AMHERST
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State | NY
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Zip | 14226-4711
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Country | US
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Telephone | 716-803-1507
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Fax | 716-803-1508
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Authorized Official
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Title or Position | OWNER
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Name | LEE RAND GUTERMAN
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Credential | M.D.
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Telephone | 716-803-1507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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