Provider Demographics
NPI:1780630194
Name:MFHS PHYSICIANS' EMERGENCY SERVICES, PC
Entity Type:Organization
Organization Name:MFHS PHYSICIANS' EMERGENCY SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:PUNDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-691-8838
Mailing Address - Street 1:305 CAYUGA RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1980
Mailing Address - Country:US
Mailing Address - Phone:716-691-8838
Mailing Address - Fax:716-564-1134
Practice Address - Street 1:1540 MAPLE RD
Practice Address - Street 2:ER
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3647
Practice Address - Country:US
Practice Address - Phone:716-568-6550
Practice Address - Fax:716-564-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000506009005OtherBC BS OF WNY
NY01618542Medicaid
NYCC5203OtherRAILROAD MEDICARE
NY00011220501OtherUNIVERA
NY=========OtherINDEPENDENT HEALTH
NY01618542Medicaid