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General NPI Number Information
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NPI Number | 1720805963
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Entity Type | Organization
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Legal Business Name | CONCERTO CARE MEDICAL GROUP OF NEW YORK, PC
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 300 INTERNATIONAL DR STE 100
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City | BUFFALO
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State | NY
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Zip | 14221-5783
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Country | US
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Telephone | 716-226-1080
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 801280
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City | KANSAS CITY
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State | MO
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Zip | 64180-1280
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Country | US
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Telephone | 949-670-6418
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Fax |
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Authorized Official
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Title or Position | MARKET MEDICAL DIRECTOR
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Name | JU JOH
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Credential | MD
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Telephone | 716-226-1080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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