Individual
DR. TERESA SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 SPINDRIFT DRIVE, WINDSONG RADIOLOGY GROUP, P.C., WILLIAMSVILLE, NY 14221-7800
(716) 631-2500
(716) 631-2500
Mailing address
55 SPINDRIFT DRIVE, WINDSONG RADIOLOGY GROUP, P.C., WILLIAMSVILLE, NY 14221-7800
(716) 631-2500
(716) 631-2500
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1314841
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000525768008
BCBS
NY
01
—
00053784005
UNIVERA
NY
05
—
01108896
—
NY
01
—
040426001394
FIDELIS
NY
01
—
300109532
RRMCR
NY
01
—
5609476
GHI
NY
Enumeration date
05/26/2006
Last updated
03/26/2014
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