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Individual

MYRON Y PRAWAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
ELM AND CARLTON ST, BUFFALO, NY 14263-5269
(716) 845-2300
Mailing address
ELM AND CARLTON ST, BUFFALO, NY 14263-0001
(716) 845-2300

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
301202
NY
2085R0202X
Diagnostic Radiology Physician
OS014021
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05870939
NY
05
101924742
PA
Enumeration date
04/18/2007
Last updated
02/09/2023
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