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General NPI Number Information
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NPI Number | 1528081809
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Entity Type | Organization
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Legal Business Name | FDR MEDICAL SERVICES P.C.
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 1540 MAPLE RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-3647
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Country | US
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Telephone | 716-568-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 275 NORTHPOINTE PKWY SUITE 50
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City | AMHERST
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State | NY
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Zip | 14228-1895
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Country | US
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Telephone | 716-834-1191
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY DIFRANCESCO
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Credential | M.D.
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Telephone | 716-677-2575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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