Provider Demographics
NPI:1134459241
Name:EXPRESS MEDICAL CARE OF WNY PLLC
Entity Type:Organization
Organization Name:EXPRESS MEDICAL CARE OF WNY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:TAKATS
Authorized Official - Suffix:III
Authorized Official - Credentials:DO
Authorized Official - Phone:716-447-8868
Mailing Address - Street 1:2949 ELMWOOD AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1356
Mailing Address - Country:US
Mailing Address - Phone:716-447-8868
Mailing Address - Fax:716-447-8892
Practice Address - Street 1:2949 ELMWOOD AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1356
Practice Address - Country:US
Practice Address - Phone:716-447-8868
Practice Address - Fax:716-447-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care