Provider Demographics
NPI:1699747964
Name:SZUMIGALA, MAXINE E (MD)
Entity type:Individual
Prefix:DR
First Name:MAXINE
Middle Name:E
Last Name:SZUMIGALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 BIG TREE RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-4116
Mailing Address - Country:US
Mailing Address - Phone:716-662-7337
Mailing Address - Fax:716-662-0641
Practice Address - Street 1:5800 BIG TREE RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-4116
Practice Address - Country:US
Practice Address - Phone:716-662-7337
Practice Address - Fax:716-662-0641
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212097208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00020521801OtherUNIVERA HEALTHCARE
NY1210759OtherINDEPENDENT HEALTH
NY01981795Medicaid
NY000525731001OtherBLUE CROSS BLUE SHIELD