Provider Demographics
NPI:1801958202
Name:BATES, VERNICE (MD)
Entity type:Individual
Prefix:
First Name:VERNICE
Middle Name:
Last Name:BATES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3980 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1727
Mailing Address - Country:US
Mailing Address - Phone:716-250-2000
Mailing Address - Fax:715-250-2040
Practice Address - Street 1:3980A SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1727
Practice Address - Country:US
Practice Address - Phone:716-250-2000
Practice Address - Fax:716-636-1365
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1500282084N0400X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0501764OtherINDEPENDENT HEALTH
NY10122740OtherFIDELIS
NY00010012102OtherUNIVERA
NY000508496002OtherBLUE CROSS & BLUE SHIELD
NY000508496007OtherBLUE CROSS & BLUE SHIELD
NY00713819Medicaid
NYCPN-N150028OtherWCB
NY130023059OtherRAILROAD MEDICARE
NY00713819Medicaid
NY130023059OtherRAILROAD MEDICARE