| Dr. Maria Jereva | |
|
1801 Grand Island Blvd Grand Island NY 14072 | |
| (716) 773-8925 | |
| (716) 692-4342 |
| Full Name | Dr. Maria Jereva |
|---|---|
| Speciality | Family Medicine |
| Location | 1801 Grand Island Blvd, Grand Island, New York |
| Authorized Official Name and Position | Maria Jereva-simonova (OWNER) |
| Authorized Official Contact | 7167738925 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Maria Jereva 908 Niagara Falls Blvd Ste. 208 N. Tonawanda NY 14120 Ph: (716) 692-3302 | Dr. Maria Jereva 1801 Grand Island Blvd Grand Island NY 14072 Ph: (716) 773-8925 |
| NPI Number | 1326133620 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 05/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326133620 | NPI | - | NPPES |
| 02080115 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 239958 (New York) | Primary |
Grand Island Primary Medical Care, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Grand Island Blvd, Grand Island, NY 14072 Phone: 716-773-8925 Fax: 716-773-8928 |