Organization
BUFFALO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PUCCIO (DIRECTOR, FINANCE)
(518) 473-0795
Entity
Organization
Contact information
Practice address
400 FOREST AVE, BUFFALO, NY 14213-1207
(716) 885-2261
Mailing address
44 HOLLAND AVE, ALBANY, NY 12229-0001
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02891087
—
NY
Enumeration date
08/15/2007
Last updated
08/27/2014
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