Provider Demographics
NPI:1700162195
Name:AQUINAS SURGICAL ASSOCIATE , PC
Entity Type:Organization
Organization Name:AQUINAS SURGICAL ASSOCIATE , PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOERR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-748-0651
Mailing Address - Street 1:81 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-1819
Mailing Address - Country:US
Mailing Address - Phone:585-748-0651
Mailing Address - Fax:
Practice Address - Street 1:81 DEER RUN
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-1819
Practice Address - Country:US
Practice Address - Phone:585-748-0651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-29
Last Update Date:2011-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150401261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical