Provider Demographics
NPI:1912946443
Name:LIPUMA, WILLIAM JOHN JR (PA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOHN
Last Name:LIPUMA
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:6245 SHERIDAN DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4834
Mailing Address - Country:US
Mailing Address - Phone:716-204-4500
Mailing Address - Fax:716-204-4501
Practice Address - Street 1:6245 SHERIDAN DR
Practice Address - Street 2:SUITE 212
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4834
Practice Address - Country:US
Practice Address - Phone:716-204-4500
Practice Address - Fax:716-204-4501
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AZ1843207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services