MEDICARE: BUFFALO DIAGNOSTIC IMAGING PLLC

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
1	261QR0200X	Radiology Clinic/Center	176164	NY

General Provider Information

NPI Number	:	1821262866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUFFALO DIAGNOSTIC IMAGING PLLC

Provider Business Mailing Address
First Line	:	4927 MAIN ST
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-4081
Country	:	US
Telephone Number	:	716-839-3333
Fax Number	:	716-839-3338

Provider Business Practice Location Address
First Line	:	4927 MAIN ST
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-4081
Country	:	US
Telephone Number	:	716-839-3333
Fax Number	:	716-839-3338

Authorized Official
Title or Position	:	MEDICAL DIRECTOR RADIOLOGIST
Name	:	DR. RONALD FEMIA
Credential	:	MD
Telephone Number	:	716-839-3333

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	04/22/2008

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