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Individual

DR. PETER WM FORGACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
405 INTERNATIONAL DR, WILLIAMSVILLE, NY 14221-5725
(716) 633-7386
(716) 633-7970
Mailing address
405 INTERNATIONAL DR, WILLIAMSVILLE, NY 14221-5725
(716) 633-7386
(716) 633-7970

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
117465
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010308501
UNIVERA PROVIDER ID
NY
01
00508006001
BLUE CROSS PROVIDER ID
NY
05
00630873
NY
01
08-03548
IHA PROVIDER ID
NY
01
117465-5
WORKERS' COMPENSATION ID
NY
01
Y019761
CHAMPUS PROVIDER ID
NY
Enumeration date
05/23/2005
Last updated
07/09/2007
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