Provider Demographics
NPI:1932377728
Name:DANA L. DRUMMOND, MD, PLLC
Entity Type:Organization
Organization Name:DANA L. DRUMMOND, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-204-0407
Mailing Address - Street 1:350 ALBERTA DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-204-0407
Mailing Address - Fax:716-204-0411
Practice Address - Street 1:350 ALBERTA DR
Practice Address - Street 2:SUITE 108
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1855
Practice Address - Country:US
Practice Address - Phone:716-204-0407
Practice Address - Fax:716-204-0411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148611261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00811963Medicaid
NYDO2285Medicare UPIN
NY00811963Medicaid