Provider Demographics
NPI:1558633560
Name:MOEEN ABU-SITTA, M.D. P.C.
Entity Type:Organization
Organization Name:MOEEN ABU-SITTA, M.D. P.C.
Other - Org Name:WNY OB GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABU-SITTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-634-0600
Mailing Address - Street 1:755 WEHRLE DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1319
Mailing Address - Country:US
Mailing Address - Phone:716-634-0600
Mailing Address - Fax:716-634-6462
Practice Address - Street 1:755 WEHRLE DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14225-1319
Practice Address - Country:US
Practice Address - Phone:716-634-0600
Practice Address - Fax:716-634-6462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183614207V00000X
NYF00468-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01230955Medicaid
NYR53477Medicare UPIN
NY01230955Medicaid