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General NPI Number Information
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NPI Number | 1740091776
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Entity Type | Organization
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Legal Business Name | WESTERN NEW YORK CANCER SPECIALIST MEDICINE PLLC
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 910 MAPLE RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-3242
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Country | US
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Telephone | 856-981-3426
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Fax |
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Provider Business Mailing Address
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Address Line | 60 KNOCHE WAY
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City | ORCHARD PARK
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State | NY
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Zip | 14127-2420
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Country | US
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Telephone | 856-981-3426
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Fax |
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Authorized Official
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Title or Position | OWNER & CEO
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Name | YASAR SHAD
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Credential |
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Telephone | 856-981-3426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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