Provider Demographics
NPI:1932379294
Name:WESTERN NEW YORK HOSPITALIST GROUP PC
Entity Type:Organization
Organization Name:WESTERN NEW YORK HOSPITALIST GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARIQ
Authorized Official - Middle Name:N
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-649-0887
Mailing Address - Street 1:170 ROTHER AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14212-1536
Mailing Address - Country:US
Mailing Address - Phone:716-649-0887
Mailing Address - Fax:716-646-4611
Practice Address - Street 1:565 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-2039
Practice Address - Country:US
Practice Address - Phone:716-826-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026235905OtherUNIVERA
NY080508000134OtherFIDELIS CARE
NYGRP530154001OtherBLUE CROSS BLUE SHIELD OF WNY
NYBA1402Medicare PIN