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General NPI Number Information
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NPI Number | 1811992019
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Entity Type | Individual
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Provider Name | MICHAEL JOHN ENDL II MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 2825 NIAGARA FALLS BLVD STE 130
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City | AMHERST
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State | NY
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Zip | 14228-2046
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Country | US
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Telephone | 716-564-2020
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Fax | 716-564-2060
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Provider Business Mailing Address
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Address Line | 6500 PORTER RD STE 2020
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-1529
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Country | US
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Telephone | 716-282-1114
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Fax | 716-282-0523
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 221211-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 221211-2
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License Number State | NY
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