Individual
MARCELINO FABIAN D'SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8750 TRANSIT RD, SUITE 205, EAST AMHERST, NY 14051-2610
(716) 639-7970
(716) 639-7968
Mailing address
908 NIAGARA FALLS BLVD STE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-3302
(716) 692-4342
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
145872
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00753975
—
NY
Enumeration date
08/19/2006
Last updated
11/29/2017
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