Individual
GREGORY T TYMCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 COLLEGE PKWY, SUITE 180, WILLIAMSVILLE, NY 14221-6800
(716) 636-1902
Mailing address
100 COLLEGE PKWY, SUITE 180, WILLIAMSVILLE, NY 14221-6800
(716) 636-1902
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
203797
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025517004
UNIVERA
—
01
—
000524750011
BLUE SHIELD OF WESTERN NY
—
01
—
1608981
INDEPENDENT HEALTH
—
01
—
2037976CR
WORKERS COMPENSATION
NY
Enumeration date
11/30/2005
Last updated
09/25/2012
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