Organization
GREAT LAKES PHYSICIAN, PC
Active
Other names
Western New York Urology Associates LLC
Organization subpart
No
Provider details
NPI number
Authorized official
K KENT CHEVLI M.D. (MANAGING PHYSICIAN)
(716) 844-5600
Entity
Organization
Contact information
Practice address
3085 HARLEM RD, SUITE 350, CHEEKTOWAGA, NY 14225-2591
(716) 844-5000
(716) 844-5050
Mailing address
3085 HARLEM RD, SUITE 350, CHEEKTOWAGA, NY 14225-2591
(716) 844-5000
(716) 844-5050
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
—
03869087
—
NY
Enumeration date
04/26/2006
Last updated
04/25/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us