| Mobile Md | |
|
656 Elmwood Ave Buffalo NY 14222-1836 | |
| (716) 204-7458 | |
| (716) 883-8764 |
| Full Name | Mobile Md |
|---|---|
| Speciality | Clinic/Center |
| Location | 656 Elmwood Ave, Buffalo, New York |
| Authorized Official Name and Position | Hongbiao Liu (PRESIDENT) |
| Authorized Official Contact | 7162047458 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Md 656 Elmwood Ave Buffalo NY 14222-1836 Ph: (716) 204-7458 | Mobile Md 656 Elmwood Ave Buffalo NY 14222-1836 Ph: (716) 204-7458 |
| NPI Number | 1568749364 |
|---|---|
| Provider Enumeration Date | 11/08/2011 |
| Last Update Date | 04/10/2019 |
| Medicare PECOS PAC ID | 6103091681 |
|---|---|
| Medicare Enrollment ID | O20111212000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568749364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 255538 (New York) | Primary |
| Provider Name | Hongbiao Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306160544 PECOS PAC ID: 2769513233 Enrollment ID: I20100628000123 |
| Provider Name | Yi Ding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750003224 PECOS PAC ID: 8325494966 Enrollment ID: I20231102000750 |
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