1073579165 NPI number — JOHN FRANCIS COYNE MD

Table of content: MARYLEE BEST (NPI 1356751309)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073579165 NPI number — JOHN FRANCIS COYNE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COYNE
Provider First Name:
JOHN
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073579165
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 ALCONA AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMHERST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14226-2201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-834-1193
Provider Business Mailing Address Fax Number:
716-834-1382

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
565 ABBOTT ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14220-2039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-828-2568
Provider Business Practice Location Address Fax Number:
716-828-2574
Provider Enumeration Date:
04/26/2006

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: 208000000X , with the licence number:  172168 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00010037105 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000506907006 . This is a "BLUE CROSS OF WNY" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 1208702 . This is a "IHA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 159912DL . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 506907009 . This is a "BCBS WNY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 008494418 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01087952 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 040426003036 . This is a "FIDELIS CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 11231903 . This is a "CAQH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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