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General NPI Number Information
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NPI Number | 1447797972
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Entity Type | Organization
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Legal Business Name | WESTERN NEW YORK MEDICAL PRACTICE P.C
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Dates
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Enumeration Date | 01/23/2017
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Last Update Date | 06/07/2019
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Provider Practice Location Address
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Address Line | 2 COULTER RD SUITE 1640
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City | CLIFTON SPRINGS
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State | NY
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Zip | 14432-1122
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Country | US
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Telephone | 315-462-1170
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Fax |
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Provider Business Mailing Address
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Address Line | 2 COULTER RD SUITE 1640
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City | CLIFTON SPRINGS
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State | NY
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Zip | 14432-1122
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Country | US
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Telephone | 315-462-1170
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Fax |
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Authorized Official
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Title or Position | VP FINANCE
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Name | CHRISTOPHER PETERSON
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Credential |
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Telephone | 585-922-0089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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