Basic Information
| Provider Information | |||||||||
| NPI: | 1487691564 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DARLING | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 160 FARBER HALL | ||||||||
| Address2: | SUNY BUFFALO | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142148001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7162043200 | ||||||||
| FaxNumber: | 7163046572 | ||||||||
| Practice Location | |||||||||
| Address1: | 2950 ELMWOOD AVE | ||||||||
| Address2: | KENMORE MERCY HOSPITAL | ||||||||
| City: | KENMORE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142171304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7162043200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 12/09/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS0010X | 236352 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207Q00000X | 236352 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0113883 | 01 | NY | INDEPENDENT HEALTH | OTHER | 236352 | 01 | NY | LICENSE | OTHER | 02785399 | 05 | NY | MEDICAID |