Provider Demographics
NPI:1851720684
Name:WESTERN NEW YORK TRUECARE MEDICAL PC
Entity Type:Organization
Organization Name:WESTERN NEW YORK TRUECARE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DHANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIJAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-435-7937
Mailing Address - Street 1:PO BOX 817
Mailing Address - Street 2:9630 TRANSIT ROAD, STE 1000
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-0817
Mailing Address - Country:US
Mailing Address - Phone:716-435-7937
Mailing Address - Fax:516-717-3137
Practice Address - Street 1:7500 PORTER RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-1604
Practice Address - Country:US
Practice Address - Phone:716-435-7937
Practice Address - Fax:516-717-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259202-1207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty