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General NPI Number Information
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NPI Number | 1689076986
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Entity Type | Organization
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Legal Business Name | CCS ONCOLOGY PC
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 10/16/2014
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Provider Practice Location Address
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Address Line | 2625 HARLEM RD SUITE 261
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City | CHEEKTOWAGA
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State | NY
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Zip | 14225-4031
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Country | US
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Telephone | 716-218-3887
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Fax |
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Provider Business Mailing Address
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Address Line | 45 SPINDRIFT DR
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7889
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Country | US
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Telephone | 716-810-9631
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WON SAM YI
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Credential | MD
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Telephone | 716-810-9631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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