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NPI Code Detail

MEDICARE: ERIC J THIERMAN MD

MEDICARE:   ERIC J THIERMAN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician219381NY
2207R00000XInternal Medicine Physician219381NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235101908
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC J THIERMAN MD
Provider Business Mailing Address
First Line : 908 NIAGARA FALLS BLVD
Second Line : SUITE 208
City : NORTH TONAWANDA
State : NY
Zip : 14120-2019
Country : US
Telephone Number : 716-692-3302
Fax Number : 716-692-4342
Provider Business Practice Location Address
First Line : 1835 MAPLE RD
Second Line :
City : WILLIAMSVILLE
State : NY
Zip : 14221-2780
Country : US
Telephone Number : 716-634-5410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 07/21/2022

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