Provider Demographics
NPI:1285692939
Name:AMHERST EAR NOSE & THROAT LLC
Entity type:Organization
Organization Name:AMHERST EAR NOSE & THROAT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-691-3500
Mailing Address - Street 1:6041 TRANSIT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:E. AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051
Mailing Address - Country:US
Mailing Address - Phone:716-691-3500
Mailing Address - Fax:716-691-3548
Practice Address - Street 1:6041 TRANSIT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:E. AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051
Practice Address - Country:US
Practice Address - Phone:716-691-3500
Practice Address - Fax:716-691-3548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA1142Medicare ID - Type Unspecified