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Organization
SHERIDAN DRIVE MEDICAL GROUP LLP
Active
Organization
SHERIDAN DRIVE MEDICAL GROUP LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNE ELIZABETH CAMPAGNA (OFFICE MANAGER)
(716) 332-4476
Entity
Organization
Contact information
Practice address
1491 SHERIDAN DR, TONAWANDA, NY 14217-1234
(716) 332-4476
(716) 332-4479
Mailing address
1491 SHERIDAN DR, TONAWANDA, NY 14217-1234
(716) 332-4476
(716) 332-4479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
183745
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
183745
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01345179
—
NY
Enumeration date
08/31/2006
Last updated
09/22/2011
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