Provider Demographics
NPI:1609959543
Name:EASTVIEW FAMILY PRACTICE PC
Entity Type:Organization
Organization Name:EASTVIEW FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRZA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-433-0554
Mailing Address - Street 1:PO BOX 1181
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14095
Mailing Address - Country:US
Mailing Address - Phone:716-433-0554
Mailing Address - Fax:716-433-0759
Practice Address - Street 1:294 EAST AVENUE
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094
Practice Address - Country:US
Practice Address - Phone:716-433-0554
Practice Address - Fax:716-433-0579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
080413Medicare ID - Type Unspecified