Provider Demographics
NPI:1073579165
Name:COYNE, JOHN FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:COYNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ALCONA AVENUE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-2201
Mailing Address - Country:US
Mailing Address - Phone:716-834-1193
Mailing Address - Fax:716-834-1382
Practice Address - Street 1:565 ABBOTT ROAD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-2039
Practice Address - Country:US
Practice Address - Phone:716-828-2568
Practice Address - Fax:716-828-2574
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172168208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010037105OtherUNIVERA
NV000506907006OtherBLUE CROSS OF WNY
NY1208702OtherIHA
NY159912DLOtherPREFERRED CARE
NY506907009OtherBCBS WNY
NY008494418Medicaid
NY01087952Medicaid
NY040426003036OtherFIDELIS CARE
NY11231903OtherCAQH
NYDD4235Medicare ID - Type Unspecified
NY00010037105OtherUNIVERA