Provider Demographics
NPI:1821128869
Name:BUFFALO AMHERST ALLERGY ASSOCIATES P.C.
Entity Type:Organization
Organization Name:BUFFALO AMHERST ALLERGY ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:716-631-0380
Mailing Address - Street 1:500 CORPORATE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1263
Mailing Address - Country:US
Mailing Address - Phone:716-631-0830
Mailing Address - Fax:716-631-3329
Practice Address - Street 1:500 CORPORATE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1263
Practice Address - Country:US
Practice Address - Phone:716-631-0830
Practice Address - Fax:716-631-3329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTIN