Provider Demographics
NPI:1013951862
Name:CARDIOVASCULAR AND THORACIC SURGERY OF WESTERN NEW YORK PLLC
Entity Type:Organization
Organization Name:CARDIOVASCULAR AND THORACIC SURGERY OF WESTERN NEW YORK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-875-1241
Mailing Address - Street 1:462 GRIDER ST
Mailing Address - Street 2:DKM BLDG, SUITE C113
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-898-5858
Mailing Address - Fax:716-961-7076
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:DKM BLDG, SUITE C113
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-898-5858
Practice Address - Fax:716-961-7076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02311044Medicaid
NYG28363Medicare PIN
CC8754Medicare UPIN