Provider Demographics
NPI:1780955799
Name:NIAGARA MEDICINE PC
Entity type:Organization
Organization Name:NIAGARA MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-298-2207
Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:N TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-3302
Mailing Address - Fax:716-332-3525
Practice Address - Street 1:5300 MILITARY RD
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-1903
Practice Address - Country:US
Practice Address - Phone:716-297-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNT ST MARY'S HOSPITAL & HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-23
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty