Individual
TIMOTHY R RASMUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2914 ELMWOOD AVE, KENMORE, NY 14217-1332
(716) 204-9729
(716) 204-9406
Mailing address
2914 ELMWOOD AVE, KENMORE, NY 14217-1332
(716) 204-9729
(716) 204-9406
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
169668
NY
2086S0129X
Vascular Surgery Physician
169668
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005109573
BLUE CROSS BLUE SHIELD
NY
05
—
01186516
—
NY
01
—
169668-1
WORKERS COMPENSATION
NY
01
—
1703238
INDEPENDENT HEALTH
NY
01
—
881517
AETNA
NY
Enumeration date
07/28/2005
Last updated
03/27/2023
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