Provider Demographics
NPI:1306247507
Name:UNIVERSITY AT BUFFALO NEUROSURGERY
Entity type:Organization
Organization Name:UNIVERSITY AT BUFFALO NEUROSURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:A
Authorized Official - Last Name:VALENTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-218-1000
Mailing Address - Street 1:100 HIGH ST
Mailing Address - Street 2:SUITE B4
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1126
Mailing Address - Country:US
Mailing Address - Phone:716-218-1000
Mailing Address - Fax:716-859-7484
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:SUITE B4
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-218-1000
Practice Address - Fax:716-859-7484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259815174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1952628315OtherCHANGE TAXONOMY CODE