MEDICARE: DR. GREGORY DAVID SAMBUCHI M.D.

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	2084N0400X	Neurology Physician	197485	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000523628001	OTHER	NY	BLUE CROSS OF WESTERN NY
3	00010155801	OTHER	NY	UNIVERA HEALTHCARE
4	0507166	OTHER	NY	INDEPENDENT HEALTH

General Provider Information

NPI Number	:	1942203112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY DAVID SAMBUCHI M.D.

Provider Business Mailing Address
First Line	:	3980 SHERIDAN DR
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-1727
Country	:	US
Telephone Number	:	716-250-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3980 SHERIDAN DR
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-1727
Country	:	US
Telephone Number	:	716-250-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	06/18/2024

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