Individual
JOHN F STANIEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
180 PARK CLUB LN, SUITE 200, WILLIAMSVILLE, NY 14221-5263
(716) 634-7350
Mailing address
180 PARK CLUB LN, SUITE 200, WILLIAMSVILLE, NY 14221-5263
(716) 634-7350
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
143100
NY
207YP0228X
Pediatric Otolaryngology Physician
143100
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000508067004
BCBS OF WNY ID
NY
01
—
00052415002
UNIVERA ID
NY
05
—
00607974
—
NY
01
—
1000417
INDEPENDENT HEALTH ID
NY
01
—
P00145049
MEDICARE RAILROAD ID
NY
Enumeration date
06/12/2006
Last updated
06/23/2010
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