Provider Demographics
NPI:1124205919
Name:AMHERST OB/GYN ASSOCIATE PC
Entity Type:Organization
Organization Name:AMHERST OB/GYN ASSOCIATE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELINO
Authorized Official - Middle Name:F
Authorized Official - Last Name:DSOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-639-7970
Mailing Address - Street 1:8750 TRANSIT RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-2610
Mailing Address - Country:US
Mailing Address - Phone:716-639-7970
Mailing Address - Fax:
Practice Address - Street 1:8750 TRANSIT RD
Practice Address - Street 2:SUITE 205
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-2610
Practice Address - Country:US
Practice Address - Phone:716-639-7970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D02281Medicare UPIN