Provider Demographics
NPI:1750524591
Name:VAIDYANATHAN, GAYATRI (MBBS)
Entity type:Individual
Prefix:DR
First Name:GAYATRI
Middle Name:
Last Name:VAIDYANATHAN
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BUFFALO MEDICAL GROUP, PC 425 ESSJAY
Mailing Address - Street 2:SUITE 170
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:
Practice Address - Street 1:295 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5795
Practice Address - Country:US
Practice Address - Phone:716-630-1343
Practice Address - Fax:716-817-1780
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278391207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology