Provider Demographics
NPI:1326469313
Name:EASTERN NIAGARA NEUROLOGY PC
Entity Type:Organization
Organization Name:EASTERN NIAGARA NEUROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BALJINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-909-6718
Mailing Address - Street 1:111 WALES AVE
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-2505
Mailing Address - Country:US
Mailing Address - Phone:716-633-7600
Mailing Address - Fax:716-633-7281
Practice Address - Street 1:170 PROFESSIONAL PARKWAY
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094
Practice Address - Country:US
Practice Address - Phone:716-909-6718
Practice Address - Fax:716-633-7281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249213-22084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty