Provider Demographics
NPI:1013453273
Name:MEDICAL HEALTH ASSOCIATES OF WESTERN NEW YORK PLLC
Entity Type:Organization
Organization Name:MEDICAL HEALTH ASSOCIATES OF WESTERN NEW YORK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:P
Authorized Official - Last Name:TIRABASSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-539-0789
Mailing Address - Street 1:8205 MAIN STREET
Mailing Address - Street 2:SUITE 14
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-539-0789
Mailing Address - Fax:716-250-9090
Practice Address - Street 1:8205 MAIN STREET
Practice Address - Street 2:SUITE 14
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-539-0789
Practice Address - Fax:716-250-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty