Individual
DR. EDGAR LACSON BANGSIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
845 ROUTE 5 & 20, IRVING, NY 14081
(716) 951-7000
(716) 951-7168
Mailing address
95 E CHAUTAUQUA ST, MAYVILLE, NY 14757-1017
(716) 753-7107
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
152589
NY
207R00000X
Internal Medicine Physician
Primary
152589
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00741300
—
NY
Enumeration date
04/17/2007
Last updated
01/08/2019
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