Individual
DR. PRAYOON PRABHARASUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2594 WILLIAM ST, NEWFANE, NY 14108-1026
(716) 778-7118
(716) 778-7119
Mailing address
2594 WILLIAM ST, NEWFANE, NY 14108-1026
(716) 778-7118
(716) 778-7119
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
115344
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020503901
UNIVERA HEALTHCARE
—
01
—
0004301613
AETNA
—
01
—
000505574001
BCBS OF WNY
NY
01
—
0028508
GHI
—
05
—
00615027
—
NY
01
—
0701266
INDEPENDENT HEALTH ASSOCI
—
01
—
10200140
FIDELIS
—
01
—
161068845001
TRICARE
—
01
—
80121005055741
BSBC GENERAL MOTORS
—
Enumeration date
12/09/2005
Last updated
05/18/2010
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