Provider Demographics
NPI:1124069844
Name:AURORA HOSPITALIST, PC
Entity type:Organization
Organization Name:AURORA HOSPITALIST, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-383-5450
Mailing Address - Street 1:400 CLIFTON CORPORATE PKWY
Mailing Address - Street 2:SUITE 428
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3839
Mailing Address - Country:US
Mailing Address - Phone:518-383-5450
Mailing Address - Fax:518-383-4223
Practice Address - Street 1:565 ABBOTT RD
Practice Address - Street 2:@MERCY HOSPITAL OF BUFFALO
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-2039
Practice Address - Country:US
Practice Address - Phone:518-383-5450
Practice Address - Fax:518-383-4223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02361993Medicaid
NYAA1473OtherGROUP MEDICARE #