Basic Information
Provider Information
NPI: 1700866753
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AFTAB
FirstName: LALARUKH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 HIGH ST
Address2: BUFFALO GENERAL HOSPITAL
City: BUFFALO
State: NY
PostalCode: 142031126
CountryCode: US
TelephoneNumber: 7168592846
FaxNumber:  
Practice Location
Address1: 207 COMMERCE DR
Address2:  
City: AMHERST
State: NY
PostalCode: 142282302
CountryCode: US
TelephoneNumber: 7166891901
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/18/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0101X206502NYY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology

No ID Information.


Home