Basic Information
Provider Information
NPI: 1538204748
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VALI
FirstName: KAVEH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 8000 DEPT # 313
Address2: UNIVERSITY AT BUFFALO SURGEONS, INC.
City: BUFFALO
State: NY
PostalCode: 142670002
CountryCode: US
TelephoneNumber: 7168985227
FaxNumber: 7168985029
Practice Location
Address1: 219 BRYANT ST.
Address2: DEPT OF SURGERY
City: BUFFALO
State: NY
PostalCode: 142222006
CountryCode: US
TelephoneNumber: 7168787137
FaxNumber: 7168787809
Other Information
ProviderEnumerationDate: 02/21/2007
LastUpdateDate: 09/14/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0120X003893NYY Allopathic & Osteopathic PhysiciansSurgeryPediatric Surgery

No ID Information.


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