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Individual

EMMANUEL PACKIANATHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
154 CAZENOVIA ST, BUFFALO, NY 14210-2436
(716) 822-2028
(716) 822-2029
Mailing address
4979 HARLEM RD, AMHERST, NY 14226-2547
(716) 923-4390
(716) 923-4394

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
203833
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01605325
NY
Enumeration date
06/04/2006
Last updated
08/19/2011
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