Organization
WESTERN NEW YORK UROLOGY ASSOCIATES, LLC
Active
Parent organization
WESTERN NEW YORK UROLOGY ASSOCIATES, LLC
Other names
Jamestown Division
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN NEW YORK UROLOGY ASSOCIATES, LLC
Authorized official
DR. PETER J WALTER MD (PHYSICIAN PARTNER)
(716) 488-1851
Entity
Organization
Contact information
Practice address
117 FOOTE AVE, JAMESTOWN, NY 14701-6947
(716) 338-9200
(716) 338-9250
Mailing address
PO BOX 1094, WHOLESALE LOCKBOX CD2, BUFFALO, NY 14240-1094
(716) 488-1851
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01417481
—
NY
Enumeration date
03/06/2007
Last updated
07/09/2010
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