Provider Demographics
NPI:1083673875
Name:WOODS, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:WOODS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NIAGARA RADIOLOGISTS, P.C.
Mailing Address - Street 2:PO BOX 8000, DEPT. 194
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0001
Mailing Address - Country:US
Mailing Address - Phone:716-692-3302
Mailing Address - Fax:716-692-4342
Practice Address - Street 1:NIAGARA FALLS MEMORIAL MEDICAL CENTER
Practice Address - Street 2:621 10TH STREET
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14302
Practice Address - Country:US
Practice Address - Phone:716-278-4000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1068192085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00809774Medicaid
NYE15485Medicare UPIN
NYB72715Medicare ID - Type Unspecified