Provider Demographics
NPI:1376617936
Name:DRUMMOND, DANA LEONCA (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LEONCA
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 ALBERTA DRIVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-204-0407
Mailing Address - Fax:716-204-0411
Practice Address - Street 1:350 ALBERTA DRIVE
Practice Address - Street 2:SUITE 108
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-204-0407
Practice Address - Fax:716-204-0411
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00811963Medicaid
NYD02285Medicare UPIN
NYRA2205Medicare ID - Type Unspecified