Provider First Line Business Practice Location Address:
77 GOODELL ST. SUITE 240T
Provider Second Line Business Practice Location Address:
UNIVERSITY AT BUFFALO DEPT. OF FAMILY MEDICINE
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-816-7258
Provider Business Practice Location Address Fax Number:
716-845-6699
Provider Enumeration Date:
04/27/2015