Individual
ANTOINE MAKDISSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 GATES CIR, BUFFALO, NY 14209-1120
(716) 887-4069
Mailing address
3 GATES CIR, BUFFALO, NY 14209-1120
(716) 887-4069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E-4722
AR
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
E-4722
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03182625
—
NY
01
—
2215941
INDEPENDENT HEALTH
NY
01
—
P00345147
RAILROAD MEDICARE 1
—
Enumeration date
10/26/2006
Last updated
11/23/2011
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