Providence Therapeutics | |
141 Elm St Apt 3c Buffalo NY 14203-2083 | |
(401) 935-2067 | |
Not Available |
Full Name | Providence Therapeutics |
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Speciality | Internal Medicine |
Location | 141 Elm St Apt 3c, Buffalo, New York |
Authorized Official Name and Position | Anthony Dunning Martinez (OWNER) |
Authorized Official Contact | 4019352067 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Providence Therapeutics 141 Elm St Apt 3c Buffalo NY 14203-2083 Ph: () - | Providence Therapeutics 141 Elm St Apt 3c Buffalo NY 14203-2083 Ph: (401) 935-2067 |
NPI Number | 1992216907 |
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Provider Enumeration Date | 10/17/2017 |
Last Update Date | 10/17/2017 |
Identifier | Type | State | Issuer |
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1992216907 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 238099 (New York) | Primary |
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