Provider Demographics
NPI:1437211414
Name:MYERS, BENNETT (MD)
Entity Type:Individual
Prefix:
First Name:BENNETT
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3980 SHERIDAN DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1727
Mailing Address - Country:US
Mailing Address - Phone:716-250-2000
Mailing Address - Fax:716-250-2040
Practice Address - Street 1:3980 SHERIDAN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-250-2000
Practice Address - Fax:716-636-1365
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2241462084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000919912003OtherBLUE CROSS & BLUE SHIELD
NY040426002143OtherFIDELIS
NYP00062399OtherRAILROAD MEDICARE
NY000919912002OtherBLUE CROSS & BLUE SHIELD
NY0511643OtherINDEPENDENT HEALTH
NY0002636001OtherUNIVERA
NY02389724Medicaid
NYH83320Medicare UPIN
NY000919912003OtherBLUE CROSS & BLUE SHIELD