Organization
BUFFALO ULTRASOUND, IDTF INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL STRAECK JR. (PRESIDENT)
(716) 631-2262
Entity
Organization
Contact information
Practice address
388 EVANS ST, WILLIAMSVILLE, NY 14221-5626
(716) 631-2262
(716) 631-2317
Mailing address
388 EVANS STREET, WILLIAMSVILLE, NY 14221-5626
(716) 634-8800
(716) 634-8987
Taxonomy
Speciality
Code
Description
License number
State
2471B0102X
Bone Densitometry Radiologic Technologist
—
NY
2471C3402X
Radiography Radiologic Technologist
—
NY
2471S1302X
Sonography Radiologic Technologist
—
NY
2471V0105X
Vascular Sonography Radiologic Technologist
—
NY
261QR0208X
Mobile Radiology Clinic/Center
—
NY
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011172401
UNIVERA
NY
01
—
0051047011
BC/BS WNY
NY
05
—
02405181
—
NY
01
—
1610947
INDEPENDENT HEALTH
NY
01
—
4100574
GHI
NY
01
—
470000919
RAILROAD MEDICARE
NY
01
—
630001671
RAILROAD MEDICARE
NY
01
—
P010169198
BC/BS ROCHESTER
NY
Enumeration date
08/24/2006
Last updated
02/05/2024
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