Shannon Fourtner, MD | |
5762 E Main Street Rd Ste B, Batavia, NY 14020-9621 | |
(585) 201-7112 | |
(585) 201-7128 |
Full Name | Shannon Fourtner |
---|---|
Gender | Female |
Speciality | Pediatrics - Pediatric Endocrinology |
Location | 5762 E Main Street Rd Ste B, Batavia, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225111651 | NPI | - | NPPES |
000528154001 | Other | BC/BS | |
050805000017 | Other | FIDELIS | |
1212950 | Other | IHA | |
1019564320001 | Other | PA MEDICAID | |
02657463 | Medicaid | NY | |
00027224401 | Other | UNIVERA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0205X | Pediatrics - Pediatric Endocrinology | 236427 (New York) | Primary |
Entity Name | University At Buffalo Pediatric Associates Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912928599 PECOS PAC ID: 1355235540 Enrollment ID: O20040210000076 |
Entity Name | Pediatric Metabolism Endercrenology |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508800376 PECOS PAC ID: 3678513579 Enrollment ID: O20050510001030 |
Mailing Address | Practice Location Address |
---|---|
Shannon Fourtner, MD 5762 E Main Street Rd Ste B, Batavia, NY 14020-9621 Ph: (585) 201-7112 | Shannon Fourtner, MD 5762 E Main Street Rd Ste B, Batavia, NY 14020-9621 Ph: (585) 201-7112 |
Daniel Gelfond, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 166 Washington Ave, Batavia, NY 14020 Phone: 585-250-4132 Fax: 585-345-4250 | |
Dr. Muhammad S Idrees, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 319 W Main St, Batavia, NY 14020 Phone: 585-599-6446 Fax: 585-637-4990 | |
Adam Joseph Olewnik, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 47 Batavia City Ctr, Batavia, NY 14020 Phone: 585-343-2611 Fax: 585-343-3826 | |
Dr. Ansar Ahmed, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 43 Batavia City Ctr, Suite A, Batavia, NY 14020 Phone: 585-343-7117 Fax: 585-343-3783 | |
Dr. Emily Fraser Branche, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 314 Ellicott St Ste 2, Batavia, NY 14020 Phone: 585-483-3081 Fax: 585-483-3084 | |
Nadezhda Danilovich, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5762 E Main Street Rd Ste B, Batavia, NY 14020 Phone: 585-201-7112 Fax: 585-201-7128 |