Provider Demographics
NPI:1740330851
Name:BUFFALO NIAGARA MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:BUFFALO NIAGARA MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-882-1212
Mailing Address - Street 1:941 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1116
Mailing Address - Country:US
Mailing Address - Phone:716-882-1212
Mailing Address - Fax:716-882-1579
Practice Address - Street 1:941 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1116
Practice Address - Country:US
Practice Address - Phone:716-882-1212
Practice Address - Fax:716-882-1579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty