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General NPI Number Information
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NPI Number | 1467802785
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Entity Type | Organization
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Legal Business Name | BUFFALO-NIAGARA CARDIOVASCULAR, PC
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 333 INTERNATIONAL DR SUITE B3
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5726
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Country | US
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Telephone | 716-909-9501
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Fax | 916-639-8181
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Provider Business Mailing Address
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Address Line | 333 INTERNATIONAL DR SUITE B3
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5726
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Country | US
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Telephone | 716-909-9501
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Fax | 916-639-8181
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VICTOR J VACANTI
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Credential | MD
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Telephone | 716-909-9501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 261739
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License Number State | NY
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