| Eden Health Medical Of De Pa | |
|
77 Goodell St Ste 510 Buffalo NY 14203-1258 | |
| (917) 261-4414 | |
| Not Available |
| Full Name | Eden Health Medical Of De Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 77 Goodell St Ste 510, Buffalo, New York |
| Authorized Official Name and Position | Rajan Shah (PRESIDENT) |
| Authorized Official Contact | 9172614414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eden Health Medical Of De Pa 77 Goodell St Ste 510 Buffalo NY 14203-1258 Ph: (917) 261-4414 | Eden Health Medical Of De Pa 77 Goodell St Ste 510 Buffalo NY 14203-1258 Ph: (917) 261-4414 |
| NPI Number | 1285397976 |
|---|---|
| Provider Enumeration Date | 10/19/2021 |
| Last Update Date | 09/13/2024 |
| Certification Date | 09/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285397976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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