1912160573 NPI number — DR. LAUREN MARIE KUWIK MD

Table of content: DR. LAUREN MARIE KUWIK MD (NPI 1912160573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912160573 NPI number — DR. LAUREN MARIE KUWIK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUWIK
Provider First Name:
LAUREN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUNFORD
Provider Other First Name:
LAUREN
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912160573
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3075 SOUTHWESTERN BLVD STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORCHARD PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14127-1236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-712-0490
Provider Business Mailing Address Fax Number:
716-712-0615

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3075 SOUTHWESTERN BLVD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORCHARD PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14127-1236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-712-0490
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  266661 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 26666 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)