Organization
EATING DISORDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN DUKARM MD (PRESIDENT)
(716) 862-1611
Entity
Organization
Contact information
Practice address
2157 MAIN ST, BUFFALO, NY 14214-2648
(716) 862-1611
(716) 692-4342
Mailing address
908 NIAGARA FALLS BLVD, SUITE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-3302
(716) 692-4342
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02527746
—
NY
Enumeration date
07/03/2006
Last updated
10/15/2007
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