Individual
EI EI CHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.B.,B.S
Contact information
Practice address
5300 MILITARY RD, LEWISTON, NY 14092-1903
(716) 297-4800
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
(518) 649-4094
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
310813
NY
Other
Enumeration date
03/18/2019
Last updated
03/20/2026
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