Provider Demographics
NPI:1235365909
Name:HEALTHY PARTNERS PROGRAM OF ERIE
Entity Type:Organization
Organization Name:HEALTHY PARTNERS PROGRAM OF ERIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-898-5207
Mailing Address - Street 1:462 GRIDER ST
Mailing Address - Street 2:ERIE COUNTY MEDICAL CTR., UB CLINICAL CTR., ROOM CC-147
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3021
Mailing Address - Country:US
Mailing Address - Phone:716-898-5207
Mailing Address - Fax:716-898-4750
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:ERIE COUNTY MEDICAL CTR., UB CLINICAL CTR., ROOM CC-147
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-5207
Practice Address - Fax:716-898-4750
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UB FAMILY MEDICINE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management