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Organization
TONAWANDA MEDICAL SERVICES, PC
Active
Organization
TONAWANDA MEDICAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZIAD I KHATIB M.D. (PHYSICIAN)
(716) 536-9409
Entity
Organization
Contact information
Practice address
843 TONAWANDA ST, BUFFALO, NY 14207-1447
(716) 536-9409
(716) 874-6660
Mailing address
PO BOX 1015, BUFFALO, NY 14207-9015
(716) 536-9409
(716) 689-4961
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
214045
NY
261QM2500X
Medical Specialty Clinic/Center
214045
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01794747
—
NY
01
—
AA1410
MEDICARE GROUP # AA1410
NY
Enumeration date
10/15/2007
Last updated
06/08/2009
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