Provider Demographics
NPI:1396787891
Name:VASCULAR & ENDOVASCULAR CENTER OF WNY, LLP
Entity type:Organization
Organization Name:VASCULAR & ENDOVASCULAR CENTER OF WNY, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-837-2400
Mailing Address - Street 1:2121 MAIN ST
Mailing Address - Street 2:SUITE 316
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2693
Mailing Address - Country:US
Mailing Address - Phone:716-692-3302
Mailing Address - Fax:716-692-4342
Practice Address - Street 1:2121 MAIN ST
Practice Address - Street 2:SUITE 316
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2693
Practice Address - Country:US
Practice Address - Phone:716-837-2400
Practice Address - Fax:716-837-3860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02065947Medicaid
NY02065947Medicaid