# ACADEMIC BUFFALONIAS IN PHYSICAL MEDICINE & REHABILITATION PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063711992
- **Authorized official:** GARY G WANG M.D. (PRESIDENT)
- **Authorized official phone:** (716) 832-1000

## Contact information

- **Practice address:** 2121 MAIN ST, SUITE 112, BUFFALO, NY 14214-2693
- **Practice address phone:** (716) 832-1000
- **Practice address fax:** (716) 832-1001
- **Mailing address:** 2121 MAIN ST, SUITE 210 SETON BLDG., BUFFALO, NY 14214-2693
- **Mailing address phone:** (716) 832-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 216631 | NY | Yes |

## Other

- **Enumeration date:** 03/17/2011
- **Last updated:** 10/04/2013