Provider Demographics
NPI:1205468055
Name:TRINITY MEDICAL WNY PC
Entity type:Organization
Organization Name:TRINITY MEDICAL WNY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-837-2400
Mailing Address - Street 1:2121 MAIN ST STE 316
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2673
Mailing Address - Country:US
Mailing Address - Phone:716-837-2400
Mailing Address - Fax:716-837-3860
Practice Address - Street 1:2121 MAIN ST STE 316
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2673
Practice Address - Country:US
Practice Address - Phone:716-837-2400
Practice Address - Fax:716-837-3860
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY MEDICAL WNY PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-10
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty