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General NPI Number Information
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NPI Number | 1851720684
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Entity Type | Organization
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Legal Business Name | WESTERN NEW YORK TRUECARE MEDICAL PC
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 03/09/2015
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Provider Practice Location Address
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Address Line | 7500 PORTER RD
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-1604
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Country | US
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Telephone | 716-435-7937
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Fax | 516-717-3137
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Provider Business Mailing Address
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Address Line | PO BOX 817 9630 TRANSIT ROAD, STE 1000
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City | EAST AMHERST
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State | NY
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Zip | 14051-0817
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Country | US
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Telephone | 716-435-7937
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Fax | 516-717-3137
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DHANYA VIJAY
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Credential | M.D
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Telephone | 716-435-7937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 259202-1
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License Number State | NY
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