1467558056 NPI number — DR. SCOTT P CHOLEWINSKI MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467558056 NPI number — DR. SCOTT P CHOLEWINSKI MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

CHOLEWINSKI

Provider First Name:

SCOTT

Provider Middle Name:

P

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

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:

1467558056

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/15/2013

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

3730 SHERIDAN DR

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:

14226-1732

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

716-633-8675

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

3730 SHERIDAN DR

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:

14226-1732

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

716-633-8675

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

09/15/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  2021561 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 2021566W . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( PW ) . This identifiers is of the category "OTHER".
• Identifier: 040426002339 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
• Identifier: 000525933001 . This is a "BLUE SHIELD OF WESTERN NY" identifier . This identifiers is of the category "OTHER".
• Identifier: 051012000083 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
• Identifier: 149935FF . This is a "PREFERRED CARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 300107155 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 00026747101 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
• Identifier: 5610990 . This is a "INDEPENDANT HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 300110830 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 000267U7102 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
• Identifier: 000525933002 . This is a "BLUE SHIELD OF WESTERN NY" identifier . This identifiers is of the category "OTHER".
• Identifier: 02058111 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".