Organization
NIAGARA MEDICINE, PC
Active
Parent organization
NIAGARA MEDICINE, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NIAGARA MEDICINE, PC
Authorized official
MR. GARY TUCKER (AUTHORIZED OFFICIAL)
(716) 601-3766
Entity
Organization
Contact information
Practice address
5300 MILITARY RD, LEWISTON, NY 14092-1903
(716) 651-0911
Mailing address
5300 MILITARY RD, LEWISTON, NY 14092-1903
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
06/01/2016
Last updated
12/27/2016
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