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General NPI Number Information
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NPI Number | 1952433757
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Entity Type | Organization
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Legal Business Name | WESTERN NEW YORK BLOODCARE, INC.
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 1010 MAIN ST STE 300
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City | BUFFALO
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State | NY
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Zip | 14202-1102
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Country | US
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Telephone | 716-896-2470
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Fax | 716-218-4010
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Provider Business Mailing Address
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Address Line | 1010 MAIN ST STE 300
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City | BUFFALO
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State | NY
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Zip | 14202-1102
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Country | US
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Telephone | 716-896-2470
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Fax | 716-218-4010
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LAUREL A REGER
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Credential | MHSA
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Telephone | 716-896-2470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 031796
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1401203R
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License Number State | NY
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