Provider Demographics
NPI:1649564865
Name:PREMIER OBGYN LLP
Entity Type:Organization
Organization Name:PREMIER OBGYN LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ERK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-631-8212
Mailing Address - Street 1:8270 WEHRLE DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7325
Mailing Address - Country:US
Mailing Address - Phone:716-631-8212
Mailing Address - Fax:716-631-8710
Practice Address - Street 1:8270 WEHRLE DRIVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILE
Practice Address - State:NY
Practice Address - Zip Code:14221-7325
Practice Address - Country:US
Practice Address - Phone:716-631-8212
Practice Address - Fax:716-631-8710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175711302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE15542Medicare UPIN