1326158593 NPI number — HIGHGATE MEDICAL GROUP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326158593 NPI number — HIGHGATE MEDICAL GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGHGATE MEDICAL GROUP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1326158593
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6255 SHERIDAN DR STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14221-8096
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-636-7979
Provider Business Mailing Address Fax Number:
716-929-0192

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3950 E ROBINSON RD STE 207
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMHERST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14228-2044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-574-1111
Provider Business Practice Location Address Fax Number:
716-929-0192
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PAWLOWSKI
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
716-636-7979

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  131001 , 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: 01483930 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: A30001607 . This is a "MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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