Provider Demographics
NPI:1700808847
Name:BARTELS,POWALSKI & WEISSMAN, MDS,PC
Entity Type:Organization
Organization Name:BARTELS,POWALSKI & WEISSMAN, MDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:L
Authorized Official - Last Name:POEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-684-5454
Mailing Address - Street 1:3834 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1039
Mailing Address - Country:US
Mailing Address - Phone:716-877-1221
Mailing Address - Fax:
Practice Address - Street 1:3834 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1039
Practice Address - Country:US
Practice Address - Phone:716-877-1221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARTELS,POWALSKI&WEISSMAN, MDS.PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-25
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02065429Medicaid
NY12201AMedicare ID - Type Unspecified