Provider Demographics
NPI:1265421564
Name:PRESS, SHALOM (MD)
Entity type:Individual
Prefix:
First Name:SHALOM
Middle Name:
Last Name:PRESS
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:PO BOX 1096
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-7096
Mailing Address - Country:US
Mailing Address - Phone:716-691-1414
Mailing Address - Fax:
Practice Address - Street 1:2550 SWEET HOME RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2225
Practice Address - Country:US
Practice Address - Phone:716-691-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY126644207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000507101001OtherBLUE CROSS BLUE SHIELD
NY0700419OtherINDEPENDENT HEALTH
NY00010141201OtherUNIVERA
NY0090546OtherGROUP HEALTH INC
NY0090546OtherGROUP HEALTH INC
D01547Medicare UPIN