Provider Demographics
NPI:1699877076
Name:SWEET HOME FAMILY MEDICINE, P.C.
Entity type:Organization
Organization Name:SWEET HOME FAMILY MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:USEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:716-861-1701
Mailing Address - Street 1:90 DAVEN DR
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1416
Mailing Address - Country:US
Mailing Address - Phone:716-568-0574
Mailing Address - Fax:
Practice Address - Street 1:1412 SWEET HOME ROAD
Practice Address - Street 2:SUITE #4
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228
Practice Address - Country:US
Practice Address - Phone:716-861-1701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211359261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care