Provider Demographics
NPI:1558304295
Name:GURU, LUBNA SYED (MD)
Entity Type:Individual
Prefix:
First Name:LUBNA
Middle Name:SYED
Last Name:GURU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 FLOSS LN
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1977
Mailing Address - Country:US
Mailing Address - Phone:716-406-2164
Mailing Address - Fax:
Practice Address - Street 1:2590 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:NEWFANE
Practice Address - State:NY
Practice Address - Zip Code:14108-1026
Practice Address - Country:US
Practice Address - Phone:716-778-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078105208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics