Individual
SUSAN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 HIGH ST, BUFFALO, NY 14203-1126
(716) 859-2573
Mailing address
100 HIGH ST, BUFFALO, NY 14203-1126
(716) 859-2573
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
178518
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010067201
EXCELLUS UNIVERA
NY
05
—
01147846
—
NY
01
—
05107491
HEALTH NOW
NY
01
—
2107559
INDEPENDENT HEALTH
NY
Enumeration date
08/21/2006
Last updated
01/03/2008
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