Provider Demographics
NPI:1114402922
Name:BUFFALO SHORE MEDICAL PLLC
Entity Type:Organization
Organization Name:BUFFALO SHORE MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-206-4590
Mailing Address - Street 1:485 CAYUGA RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1368
Mailing Address - Country:US
Mailing Address - Phone:716-206-4590
Mailing Address - Fax:
Practice Address - Street 1:3800 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1094
Practice Address - Country:US
Practice Address - Phone:716-873-3828
Practice Address - Fax:716-873-5463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty