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Organization
SOUTHTOWNS NEUROLOGY OF WESTERN NEW YORK PC
Active
Organization
SOUTHTOWNS NEUROLOGY OF WESTERN NEW YORK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETERKIN LEEKWEN M.D. (CEO)
(716) 712-0890
Entity
Organization
Contact information
Practice address
3775 SENECA ST, WEST SENECA, NY 14224-3434
(716) 712-0890
(716) 712-0933
Mailing address
3775 SENECA ST, WEST SENECA, NY 14224-3434
(716) 712-0890
(716) 712-0933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
206950
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02731060
—
NY
Enumeration date
06/25/2007
Last updated
10/13/2015
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