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8912 Hebdon Rd West Valley NY 14171-9741 | |
(716) 942-3219 | |
(716) 942-3977 |
Full Name | |
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Speciality | Family Medicine |
Location | 8912 Hebdon Rd, West Valley, New York |
Authorized Official Name and Position | Timothy V Siepel (OWNER) |
Authorized Official Contact | 7169423219 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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8912 Hebdon Rd West Valley NY 14171-9741 Ph: (716) 942-3219 | 8912 Hebdon Rd West Valley NY 14171-9741 Ph: (716) 942-3219 |
NPI Number | 1073613014 |
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Provider Enumeration Date | 09/22/2006 |
Last Update Date | 10/05/2011 |
Medicare PECOS PAC ID | 6709808157 |
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Medicare Enrollment ID | O20051228000546 |
Identifier | Type | State | Issuer |
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1073613014 | NPI | - | NPPES |
006266-64 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Timothy V Siepel |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053348599 PECOS PAC ID: 8426070871 Enrollment ID: I20051228000597 |