Provider Demographics
NPI:1992161582
Name:RHEUMATOLOGY WELLNESS CARE OF WNY, PLLC
Entity type:Organization
Organization Name:RHEUMATOLOGY WELLNESS CARE OF WNY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:O'NEIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-898-0755
Mailing Address - Street 1:20 LOSSON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-2394
Mailing Address - Country:US
Mailing Address - Phone:716-898-0755
Mailing Address - Fax:716-898-0775
Practice Address - Street 1:20 LOSSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-2394
Practice Address - Country:US
Practice Address - Phone:716-898-0755
Practice Address - Fax:716-898-0775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA188049-1261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01885107Medicaid
NYBB2046Medicare UPIN