Great Lakes Physician, Pc in Cheektowaga - Urology
Great Lakes Physician, Pc - NPI 1720045792
Great Lakes Physician, Pc is a Urology in Cheektowaga, New York. Great Lakes Physician, Pc practices all healthcare services and medical treatments related to Urology. The NPI Number for Great Lakes Physician, Pc is 1720045792. The last update date is 2017-04-25.
Great Lakes Physician, Pc's current location address is 3085 Harlem Rd, Cheektowaga, New York. You can contact this provider via phone number 7168445000 and fax number 7168445050. The mailing address for Great Lakes Physician, Pc is 3085 Harlem Rd, Cheektowaga, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Great Lakes Physician, Pc |
|---|---|
| Address | 3085 Harlem Rd, Cheektowaga, New York |
| Phone Number | 7168445000 |
| Fax Number | 7168445050 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MANAGING P |
|---|---|
| Authorized Official Name | Chevli Kent K |
| Credentials | M.D. |
| Telephone Number | 7168445600 |
NPI Number Detail
| NPI Number | 1720045792 |
|---|---|
| Provider Enumeration Date | 2006-04-26 |
| Last Updated Date | 2017-04-25 |
Provider Mailing Address Detail
| Address | 3085 Harlem Rd |
|---|---|
| City | Cheektowaga |
| State | New York (NY) |
| Post Code | 142252591 |
| Phone Number | 7168445000 |
| Fax Number | 7168445050 |
Provider's Primary Taxonomy Detail
| Speciality | Urology |
|---|---|
| Taxonomy | 208800000X |
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Definition: A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquir |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3869087 | NY | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Great Lakes Physician, Pc by the Centers for Medicare & Medicaid Services?
The Great Lakes Physician, Pc has been assigned the NPI (National Provider Identifier) 1720045792. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Great Lakes Physician, Pc is located?
The Great Lakes Physician, Pc is situated at the following address: 3085 Harlem Rd, Cheektowaga, NY, 142252591.
What is the Great Lakes Physician, Pc's specialty and taxonomy code?
The Great Lakes Physician, Pc's specialty is Urology, and the corresponding taxonomy code is 208800000X.
On what date did Great Lakes Physician, Pc receive its 1720045792 assignment from the Centers for Medicare & Medicaid Services?
The Great Lakes Physician, Pc was assigned its 1720045792 on 2006-04-26, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Great Lakes Physician, Pc most recently updated or refreshed?
The details pertaining to the Great Lakes Physician, Pc, including its address, specialty, and other relevant information, were last updated or refreshed on 2017-04-25.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY