Provider Demographics
NPI:1497059372
Name:BUFFALO NEUROSURGERY P.C.
Entity Type:Organization
Organization Name:BUFFALO NEUROSURGERY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-204-0028
Mailing Address - Street 1:550 ORCHARD PARK RD
Mailing Address - Street 2:SUITE A105
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2646
Mailing Address - Country:US
Mailing Address - Phone:716-677-6000
Mailing Address - Fax:716-677-6006
Practice Address - Street 1:180 PARK CLUB LN
Practice Address - Street 2:SUITE 100
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5263
Practice Address - Country:US
Practice Address - Phone:716-839-9402
Practice Address - Fax:716-839-3570
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUFFALO NEUROSURGERY P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-06
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6471990001Medicare NSC