Provider Demographics
NPI:1831608033
Name:WOUND MEDICAL CARE OF WNY PLLC
Entity type:Organization
Organization Name:WOUND MEDICAL CARE OF WNY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-689-1901
Mailing Address - Street 1:405 N FRENCH RD STE 104
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2010
Mailing Address - Country:US
Mailing Address - Phone:716-689-1901
Mailing Address - Fax:
Practice Address - Street 1:229 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1645
Practice Address - Country:US
Practice Address - Phone:585-344-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty