Provider Demographics
NPI:1003806746
Name:PARKVIEW PRIMARY CARE PHYSICIANS, PLLC
Entity type:Organization
Organization Name:PARKVIEW PRIMARY CARE PHYSICIANS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAVCIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-558-7727
Mailing Address - Street 1:20 LOSSON RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-2394
Mailing Address - Country:US
Mailing Address - Phone:716-558-7727
Mailing Address - Fax:
Practice Address - Street 1:20 LOSSON RD
Practice Address - Street 2:SUITE 105
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-2394
Practice Address - Country:US
Practice Address - Phone:716-558-7727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202290207Q00000X
NY164517207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty