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General NPI Number Information
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NPI Number | 1679668305
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Entity Type | Individual
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Provider Name | THOMAS A DIAKUN M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 2121 MAIN STREET SUITE 209
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City | BUFFALO
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State | NY
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Zip | 14214
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Country | US
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Telephone | 716-836-7510
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Fax | 716-836-7511
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Provider Business Mailing Address
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Address Line | 2121 MAIN ST SUITE 209
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City | BUFFALO
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State | NY
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Zip | 14214-2693
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Country | US
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Telephone | 716-836-7510
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Fax | 716-836-7511
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 169375-1
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License Number State | NY
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