Provider Demographics
NPI:1023214723
Name:EDGARDO F SALVADOR MD PC
Entity Type:Organization
Organization Name:EDGARDO F SALVADOR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:F
Authorized Official - Last Name:SALVADOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-832-2920
Mailing Address - Street 1:3140 SHERIDAN DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1911
Mailing Address - Country:US
Mailing Address - Phone:716-832-2920
Mailing Address - Fax:716-832-2956
Practice Address - Street 1:3140 SHERIDAN DR
Practice Address - Street 2:STE 201
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1911
Practice Address - Country:US
Practice Address - Phone:716-832-2920
Practice Address - Fax:716-832-2956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178811207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F58089Medicare UPIN