Basic Information
| Provider Information | |||||||||
| NPI: | 1225204415 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BUFFALO INTERNAL MEDICINE, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1688 | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142401688 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166348800 | ||||||||
| FaxNumber: | 7166348987 | ||||||||
| Practice Location | |||||||||
| Address1: | 2950 ELMWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | KENMORE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142171304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166348800 | ||||||||
| FaxNumber: | 7166348987 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2008 | ||||||||
| LastUpdateDate: | 05/07/2008 | ||||||||
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| AuthorizedOfficialLastName: | BREWER | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7166348800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 231159 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.