# EATING DISORDERS, LLC

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

## Provider details

- **NPI number:** 1336179795
- **Authorized official:** CAROLYN DUKARM MD (PRESIDENT)
- **Authorized official phone:** (716) 862-1611

## Contact information

- **Practice address:** 2157 MAIN ST, BUFFALO, NY 14214-2648
- **Practice address phone:** (716) 862-1611
- **Practice address fax:** (716) 692-4342
- **Mailing address:** 908 NIAGARA FALLS BLVD, SUITE 208, NORTH TONAWANDA, NY 14120-2019
- **Mailing address phone:** (716) 692-3302
- **Mailing address fax:** (716) 692-4342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/03/2006
- **Last updated:** 10/15/2007