1902025513 NPI number — ABBOTT ANESTHESIOLOGIST ASSOCIATES PC

Table of content: (NPI 1902025513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902025513 NPI number — ABBOTT ANESTHESIOLOGIST ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABBOTT ANESTHESIOLOGIST ASSOCIATES PC
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:
1902025513
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
515 ABBOTT RD
Provider Second Line Business Mailing Address:
SUITE 410
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14220-1700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-826-6628
Provider Business Mailing Address Fax Number:
716-828-3448

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
565 ABBOTT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14220-2039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-826-6628
Provider Business Practice Location Address Fax Number:
716-828-3448
Provider Enumeration Date:
04/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JARMUZ
Authorized Official First Name:
PAT
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
716-826-6628

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1083688170 . This is a "LAKSHMANA RAO KONERU" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1588637680 . This is a "GEORGE H. BANCROFT" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1922071026 . This is a "GREGORY V. TOBIAS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1487627584 . This is a "KENYON W. JONES" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1467425199 . This is a "IRIS M. HUDSON" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1912973629 . This is a "NISHI HARVEY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1225002405 . This is a "ASHOK NYLAKONDA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1548233646 . This is a "GEORGE TURCO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1003889106 . This is a "SALVATORE J. PARLATO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1306819313 . This is a "STEVEN MOSHIDES" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1356314470 . This is a "BAL K. KAOUR" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1508839580 . This is a "DAVID F. MANGAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1528031622 . This is a "SIVA KRISH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1801869938 . This is a "STEPHEN C. GLADYSZ" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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