Provider Demographics
NPI:1801447388
Name:AKL MEDICAL PC
Entity type:Organization
Organization Name:AKL MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:ELIAS
Authorized Official - Last Name:AKL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-373-7440
Mailing Address - Street 1:2626 W STATE ST STE 205
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1858
Mailing Address - Country:US
Mailing Address - Phone:716-373-7440
Mailing Address - Fax:716-737-5725
Practice Address - Street 1:2626 W STATE ST STE 205
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1858
Practice Address - Country:US
Practice Address - Phone:716-373-7440
Practice Address - Fax:716-737-5725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01715911Medicaid