Organization
NIAGARA UROLOGY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAIRAT BUTSUNTURN MD (PRESIDENT)
(716) 285-3464
Entity
Organization
Contact information
Practice address
1 COLOMBA DR, SUITE 2, NIAGARA FALLS, NY 14305-1205
(716) 285-3464
(716) 285-8520
Mailing address
1 COLOMBA DR, SUITE 2, NIAGARA FALLS, NY 14305-1205
(716) 285-3464
(716) 285-8520
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009353099
GHI
NY
01
—
0111170
FIDELIS
NY
01
—
33D0681581
CLIA#
NY
01
—
GRP506680001
BLUE CROSS BLUE SHIELD
NY
Enumeration date
11/02/2006
Last updated
07/19/2011
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