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EATING DISORDERS LLC NPI 1336179795


NPI Information

NPI: 1336179795
Provider Name: EATING DISORDERS, LLC
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
2157 MAIN ST
BUFFALO, NY
ZIP 14214
Phone: (716) 862-1611
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EATING DISORDERS, LLC is an adolescent medicine pediatrics in Buffalo, NY. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. EATING DISORDERS, LLC NPI is 1336179795. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2157 MAIN ST
BUFFALO, NY
ZIP 14214-648
Phone: (716) 862-1611
Fax: (716) 692-4342

The provider's authorized official is Carolyn Dukarm .
The authorized official title is President and has the following contact phone number (716) 862-1611.

The enumeration date for this NPI number is 7/3/2006 and was last updated on 10/15/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080A0000XPediatricsAdolescent MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1AA1221MEDICARE PINNEW YORK
202527746MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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