Organization
THE BUFFALO ATHLETIC CLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD RUGG (PRESIDENT)
(716) 845-6660
Entity
Organization
Contact information
Practice address
69 DELAWARE AVE, BUFFALO, NY 14202-3812
(716) 845-6660
(716) 847-0313
Mailing address
69 DELAWARE AVE, BUFFALO, NY 14202-3812
(716) 845-6660
(716) 847-0313
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000585200001
BLUE CROSS BLUE SHIELD OF WESTERN NEW YORK
NY
Enumeration date
09/21/2009
Last updated
09/21/2009
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