Blue Buffalo Primary Care | |
2545 Sheridan Dr Ste 4 Tonawanda NY 14150-9478 | |
(716) 844-9716 | |
Not Available |
Full Name | Blue Buffalo Primary Care |
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Speciality | Family Medicine |
Location | 2545 Sheridan Dr Ste 4, Tonawanda, New York |
Authorized Official Name and Position | Robert Lugo (OWNER) |
Authorized Official Contact | 7168449716 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Blue Buffalo Primary Care 213 Burbank Dr Amherst NY 14226-3938 Ph: (716) 844-9716 | Blue Buffalo Primary Care 2545 Sheridan Dr Ste 4 Tonawanda NY 14150-9478 Ph: (716) 844-9716 |
NPI Number | 1700656535 |
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Provider Enumeration Date | 01/03/2024 |
Last Update Date | 01/03/2024 |
Medicare PECOS PAC ID | 3870930324 |
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Medicare Enrollment ID | O20240320002076 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700656535 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Robert G Lugo |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700179827 PECOS PAC ID: 6406073311 Enrollment ID: I20140815001183 |
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