Provider Demographics
NPI:1801122072
Name:SUNY BUFFALO
Entity type:Organization
Organization Name:SUNY BUFFALO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HONGBIAO
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-498-6665
Mailing Address - Street 1:63 MAPLE CT APT 4
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3632
Mailing Address - Country:US
Mailing Address - Phone:310-498-6665
Mailing Address - Fax:
Practice Address - Street 1:3435 MAIN ST.
Practice Address - Street 2:105 PARKER HALL
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214
Practice Address - Country:US
Practice Address - Phone:716-838-5889
Practice Address - Fax:716-838-4918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital