Provider Demographics
NPI:1083976898
Name:NIAGARA UNIVERSITY HEALTH SERVICES
Entity Type:Organization
Organization Name:NIAGARA UNIVERSITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOOS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,BSN
Authorized Official - Phone:716-286-8390
Mailing Address - Street 1:5795 LEWISTON RD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA UNIVERSITY
Mailing Address - State:NY
Mailing Address - Zip Code:14109-9809
Mailing Address - Country:US
Mailing Address - Phone:716-286-8390
Mailing Address - Fax:716-286-8391
Practice Address - Street 1:5795 LEWISTON RD
Practice Address - Street 2:
Practice Address - City:NIAGARA UNIVERSITY
Practice Address - State:NY
Practice Address - Zip Code:14109-9809
Practice Address - Country:US
Practice Address - Phone:716-286-8390
Practice Address - Fax:716-286-8391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service