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General NPI Number Information
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NPI Number | 1790834760
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Entity Type | Organization
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Legal Business Name | TCD MEDICAL TESTING PLLC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 03/20/2019
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Provider Practice Location Address
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Address Line | 373 DAN TROY DR
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-3513
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Country | US
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Telephone | 716-250-2002
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Fax |
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Provider Business Mailing Address
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Address Line | 373 DAN TROY DR
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-3513
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT
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Name | JILL BUDZINSKI
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Credential |
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Telephone | 716-331-3555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 61619
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License Number State | NY
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