Provider Demographics
NPI:1235122326
Name:BECK, FREDERICK K (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:K
Last Name:BECK
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 1:7954 TRANSIT RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4117
Mailing Address - Country:US
Mailing Address - Phone:716-688-4226
Mailing Address - Fax:716-636-0709
Practice Address - Street 1:7954 TRANSIT RD
Practice Address - Street 2:SUITE 302
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4117
Practice Address - Country:US
Practice Address - Phone:716-688-4226
Practice Address - Fax:716-636-0709
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125784207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00598045Medicaid
B36061Medicare UPIN
B36061Medicare UPIN