Provider First Line Business Practice Location Address:
462 GRIDER ST
Provider Second Line Business Practice Location Address:
UB SURGERY RESIDENCY PROGRAM - ECMC DK MILLER BLDG, 3RD
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14215-3021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-898-6515
Provider Business Practice Location Address Fax Number:
716-898-5029
Provider Enumeration Date:
04/06/2017