Provider Demographics
NPI:1811992019
Name:ENDL, MICHAEL JOHN II (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:ENDL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6500 PORTER RD
Mailing Address - Street 2:STE 2020
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-1529
Mailing Address - Country:US
Mailing Address - Phone:716-282-1114
Mailing Address - Fax:716-282-0523
Practice Address - Street 1:2825 NIAGARA FALLS BLVD
Practice Address - Street 2:STE 130
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2046
Practice Address - Country:US
Practice Address - Phone:716-564-2020
Practice Address - Fax:716-564-2060
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2020-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY221211-1207W00000X
NY221211-2174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000526479002OtherCOMMUNITY BLUE
NY0811207OtherIHA
NY161578122OtherNOVA
NY251744484OtherEMPIRE - UNITED HEALTHCAR
NY00010055201OtherUNIVERA
NY161578122OtherAMERISIGHT
NY161578122OtherVISION LCA
NY251744484OtherNOVA
NYP00412802OtherMEDICARE RAIL ROAD
NY251744484OtherNORTH AMERICAN PREFERRED
NY000526479001OtherCOMMUNITY BLUE
NY02422351Medicaid
NY161578122OtherNORTH AMERICAN PREFERRED
NY251744484OtherNOVA
NY251744484OtherEMPIRE - UNITED HEALTHCAR
NYCC5688Medicare PIN