Organization
BLT MEDICAL GROUP, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEROY W MCCUNE MD (PRESIDENT)
(716) 651-0911
Entity
Organization
Contact information
Practice address
1026 UNION RD, WEST SENECA, NY 14224-3445
(716) 712-1030
Mailing address
3719 UNION RD, SUITE 218, CHEEKTOWAGA, NY 14225-4249
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02782070
—
NY
Enumeration date
06/28/2006
Last updated
01/26/2017
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