Provider Demographics
NPI:1184608911
Name:NEU, JEFFERY R (MD)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:R
Last Name:NEU
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 1:6460 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-634-5100
Mailing Address - Fax:716-634-5134
Practice Address - Street 1:6460 MAIN ST
Practice Address - Street 2:BUFFALO CARDIOLOGY & PULMONARY ASSOC PC
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-634-5100
Practice Address - Fax:716-634-5134
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185150207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1233090Medicaid
NY2803605OtherINDEP HEALTH
NY00010126601OtherUNIVERA
NY000511530001OtherBLUE CROSS COMM BLUE
NY2803605OtherINDEP HEALTH
NY1233090Medicaid
NYY67171Medicare ID - Type Unspecified