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General NPI Number Information
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NPI Number | 1538466511
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Entity Type | Organization
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Legal Business Name | DIANE J. SUTTER, M.D., LLC
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 3800 DELAWARE AVENUE SUITE 102
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City | KENMORE
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State | NY
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Zip | 14217
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Country | US
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Telephone | 716-650-5548
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Fax | 716-783-8557
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Provider Business Mailing Address
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Address Line | 3800 DELAWARE AVENUE SUITE 200
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City | KENMORE
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State | NY
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Zip | 14217
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Country | US
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Telephone | 716-650-5548
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Fax | 716-674-6070
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | MRS. DIANE J SUTTER
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Credential | M.D.
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Telephone | 716-650-5548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State | NY
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