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General NPI Number Information
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NPI Number | 1497758064
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Entity Type | Individual
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Provider Name | DANIEL ANDREW LEARY III MD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 09/16/2015
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Provider Practice Location Address
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Address Line | 3041 ORCHARD PARK RD D
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1208
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Country | US
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Telephone | 716-671-8393
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Fax | 716-671-8398
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Provider Business Mailing Address
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Address Line | 3041 ORCHARD PARK RD D
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1208
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Country | US
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Telephone | 716-671-8393
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Fax | 716-671-8398
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 143061
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License Number State | NY
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