Provider Demographics
NPI:1730281627
Name:FAMILY CARE MEDICINE PC
Entity Type:Organization
Organization Name:FAMILY CARE MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:PANZARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:716-833-2200
Mailing Address - Street 1:1208 NIAGARA FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-8924
Mailing Address - Country:US
Mailing Address - Phone:716-833-2200
Mailing Address - Fax:716-833-3707
Practice Address - Street 1:1208 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-8924
Practice Address - Country:US
Practice Address - Phone:716-833-2200
Practice Address - Fax:716-833-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF00818Medicare UPIN