Provider Demographics
NPI:1194915371
Name:ATWAL, EPHRAIM S (MD)
Entity type:Individual
Prefix:
First Name:EPHRAIM
Middle Name:S
Last Name:ATWAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3095 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2500
Mailing Address - Country:US
Mailing Address - Phone:716-896-8831
Mailing Address - Fax:716-896-2318
Practice Address - Street 1:3095 HARLEM RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2500
Practice Address - Country:US
Practice Address - Phone:716-896-8831
Practice Address - Fax:716-896-2318
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2011-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY7388633207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1000540Medicaid