Provider Demographics
NPI:1003807132
Name:PROSCAN RADIOLOGY BUFFALO, PLLC
Entity Type:Organization
Organization Name:PROSCAN RADIOLOGY BUFFALO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR, CORPORATE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:AMAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-924-5174
Mailing Address - Street 1:5214 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5373
Mailing Address - Country:US
Mailing Address - Phone:716-839-2600
Mailing Address - Fax:716-839-6700
Practice Address - Street 1:5214 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5373
Practice Address - Country:US
Practice Address - Phone:716-839-2600
Practice Address - Fax:716-839-6700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDB9023OtherRAILROAD MEDICARE
NYBA0186Medicare PIN