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General NPI Number Information
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NPI Number | 1477821361
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Entity Type | Organization
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Legal Business Name | UNIVERA COMMUNITY HEALTH, INC.
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 205 PARK CLUB LN
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City | BUFFALO
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State | NY
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Zip | 14221-5239
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Country | US
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Telephone | 585-238-4554
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Fax |
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Provider Business Mailing Address
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Address Line | 205 PARK CLUB LN
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City | BUFFALO
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State | NY
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Zip | 14221-5239
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Country | US
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Telephone | 585-238-4554
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, NYS GOV'T PROGRAMS FINANC
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Name | BRANDI BISHOP
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Credential |
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Telephone | 585-238-4554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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