Provider Demographics
NPI:1477132843
Name:OWITZ, MICHAEL SETH
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SETH
Last Name:OWITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 GRIDER ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3098
Mailing Address - Country:US
Mailing Address - Phone:716-831-8612
Mailing Address - Fax:716-898-5719
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3098
Practice Address - Country:US
Practice Address - Phone:716-831-8612
Practice Address - Fax:716-898-5719
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program