Individual
BRIAN MADOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1176 MAIN ST, BUFFALO, NY 14209-2102
(716) 881-7900
(716) 881-4349
Mailing address
1176 MAIN ST, BUFFALO, NY 14209-2102
(716) 881-7900
(716) 881-4349
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
247586
NY
207W00000X
Ophthalmology Physician
ME101419
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000388000
—
FL
05
—
06463721
—
NY
01
—
53733
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/09/2007
Last updated
03/22/2022
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