Provider Demographics
NPI:1467802785
Name:BUFFALO-NIAGARA CARDIOVASCULAR, PC
Entity Type:Organization
Organization Name:BUFFALO-NIAGARA CARDIOVASCULAR, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:VACANTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-909-9501
Mailing Address - Street 1:333 INTERNATIONAL DR
Mailing Address - Street 2:SUITE B3
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5726
Mailing Address - Country:US
Mailing Address - Phone:716-909-9501
Mailing Address - Fax:916-639-8181
Practice Address - Street 1:333 INTERNATIONAL DR
Practice Address - Street 2:SUITE B3
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5726
Practice Address - Country:US
Practice Address - Phone:716-909-9501
Practice Address - Fax:916-639-8181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261739207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
J300052994Medicare PIN