Provider Demographics
NPI:1619484193
Name:WESTERN NEW YORK BREAST IMAGING, P.C.
Entity Type:Organization
Organization Name:WESTERN NEW YORK BREAST IMAGING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-839-3333
Mailing Address - Street 1:4925 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4000
Mailing Address - Country:US
Mailing Address - Phone:716-839-3333
Mailing Address - Fax:716-839-3338
Practice Address - Street 1:4925 MAIN ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4000
Practice Address - Country:US
Practice Address - Phone:716-839-3333
Practice Address - Fax:716-839-3338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty