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AJITKUMAR TAMPI TRIVIKRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
151 BUFFALO AVE, SUITE 211, NIAGARA FALLS, NY 14303-1243
(716) 282-0400
(716) 284-8085
Mailing address
151 BUFFALO AVE, SUITE 211, NIAGARA FALLS, NY 14303-1243
(716) 282-0400
(716) 284-8085

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
118628
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010180201
UNIVERA
NY
05
00603085
NY
01
3100688
INDEPENDANT HEALTH
NY
01
5066883
BLUE CROSS BLUE SHIELD
NY
Enumeration date
06/12/2006
Last updated
01/14/2008
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