1720378722 NPI number — SUZANNE J. MEYERS, M.D., P.C.

Table of content: (NPI 1720378722)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720378722 NPI number — SUZANNE J. MEYERS, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUZANNE J. MEYERS, M.D., P.C.
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:
1720378722
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3580 SHERIDAN DR
Provider Second Line Business Mailing Address:
STE 110
Provider Business Mailing Address City Name:
AMHERST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14226-1645
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-831-0102
Provider Business Mailing Address Fax Number:
716-831-0800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3580 SHERIDAN DR
Provider Second Line Business Practice Location Address:
STE 110
Provider Business Practice Location Address City Name:
AMHERST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14226-1645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-831-0102
Provider Business Practice Location Address Fax Number:
716-831-0800
Provider Enumeration Date:
04/11/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MEYERS
Authorized Official First Name:
SUZANNE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
716-831-0102

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  167452-1 , 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: 000000000 . This is a "MERITAIN HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00010117901 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000504288001 . This is a "BLUE CROSS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0707219 . This is a "INDEPENDENT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0707219 . This is a "AZEROS HEALTH PLAN/NOVA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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