Organization
PHYSICIANS PRACTICE OF EASTERN NIAGARA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ICKOWSKI (CFO)
(716) 514-5501
Entity
Organization
Contact information
Practice address
15 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 692-3302
(716) 213-0935
Mailing address
908 NIAGARA FALLS BLVD, SUITE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-2160
(716) 213-0935
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0102X
Surgical Critical Care Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
Other
Enumeration date
01/13/2014
Last updated
01/13/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up