Provider Demographics
NPI:1285632208
Name:BYUN, STANLEY Y (MD)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:Y
Last Name:BYUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:ELM AND CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14263-0001
Mailing Address - Country:US
Mailing Address - Phone:716-845-2300
Mailing Address - Fax:716-845-8254
Practice Address - Street 1:ELM AND CARLTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:716-845-8254
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1645952085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01033545Medicaid
NY3705738OtherINDEPENDENT HEALTH
NY000524495002OtherBLUE CROSS BLUE SHIELD
NY00020516701OtherUNIVERA
NY00020516701OtherUNIVERA
NYJ400000502Medicare PIN