Provider Demographics
NPI:1821171257
Name:NADLER, DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:NADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 HARLEM RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3803
Mailing Address - Country:US
Mailing Address - Phone:716-839-6720
Mailing Address - Fax:716-839-6740
Practice Address - Street 1:219 BRYANT ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2006
Practice Address - Country:US
Practice Address - Phone:716-888-1300
Practice Address - Fax:716-888-1315
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116050208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026202601OtherUNIVERA
0019061890001OtherPA MEDICAID
NY02291376Medicaid
NY000526905001OtherBC/BS
NY040426002888OtherFIDELIS
NY1211455OtherIHA