Provider Demographics
NPI:1407041841
Name:DIBENEDETTO, SCHRATZ & HODGE, MD'S PC
Entity Type:Organization
Organization Name:DIBENEDETTO, SCHRATZ & HODGE, MD'S PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SCHRATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-434-6141
Mailing Address - Street 1:15 ELIZABETH DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-5226
Mailing Address - Country:US
Mailing Address - Phone:716-434-6141
Mailing Address - Fax:716-434-0594
Practice Address - Street 1:15 ELIZABETH DR
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-5226
Practice Address - Country:US
Practice Address - Phone:716-434-6141
Practice Address - Fax:716-434-0594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1761681208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty