Basic Information
| Provider Information | |||||||||
| NPI: | 1952621666 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAGAI | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | Y | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | ERIE COUNTY MEDICAL CENTER - DEPT. PLASTIC SURGERY | ||||||||
| Address2: | 462 GRIDER STREET | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168983073 | ||||||||
| FaxNumber: | 7168985587 | ||||||||
| Practice Location | |||||||||
| Address1: | 3435 MAIN ST | ||||||||
| Address2: | 112 SQUIRE HALL | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142143001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168296637 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2010 | ||||||||
| LastUpdateDate: | 11/04/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204E00000X | 282223 | NY | N | Allopathic & Osteopathic Physicians | Oral & Maxillofacial Surgery | 2086X0206X | 282223 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology |
No ID Information.