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General NPI Number Information
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NPI Number | 1780852780
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Entity Type | Organization
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Legal Business Name | ROMANTH WAGHMARAE MB., BCH., PC
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 04/12/2018
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Provider Practice Location Address
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Address Line | 6245 SHERIDAN DR SUITE 116
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-4834
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Country | US
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Telephone | 716-505-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 6245 SHERIDAN DR STE 116
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-4827
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Country | US
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Telephone | 716-505-1500
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTATOR
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Name | MRS. MIRIAM SHAPIRO
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Credential |
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Telephone | 716-250-7420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 171388
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License Number State | NY
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