Provider Demographics
NPI: | 1528010766 |
---|---|
Name: | JAMESTOWN AREA MEDICAL ASSOCIATES, L.L.P. |
Entity Type: | Organization |
Organization Name: | JAMESTOWN AREA MEDICAL ASSOCIATES, L.L.P. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KEVIN |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | SAFF |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 716-488-1877 |
Mailing Address - Street 1: | 15 S MAIN ST |
Mailing Address - Street 2: | SUITE 300 |
Mailing Address - City: | JAMESTOWN |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 14701-6636 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 716-488-1877 |
Mailing Address - Fax: | 716-488-1986 |
Practice Address - Street 1: | 15 S MAIN ST |
Practice Address - Street 2: | SUITE 300 |
Practice Address - City: | JAMESTOWN |
Practice Address - State: | NY |
Practice Address - Zip Code: | 14701-6636 |
Practice Address - Country: | US |
Practice Address - Phone: | 716-488-1877 |
Practice Address - Fax: | 716-488-1986 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-05-16 |
Last Update Date: | 2014-01-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
207R00000X, 207RC0000X, 207RG0100X, 207RN0300X, 207RP1001X, 207UN0901X, 207V00000X, 207X00000X, 207ZP0102X, 2085R0202X, 208600000X | ||
NY | 013382 | 363AM0700X |
NY | 007976 | 363AS0400X |
NY | F332351 | 363LA2200X |
NY | F420089 | 363LW0102X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207UN0901X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | Group - Multi-Specialty |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
No | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | Group - Multi-Specialty |
No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
No | 363LW0102X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | Group - Multi-Specialty |