Eden Health Medical Of Ma PC
Internal Medicine in Buffalo, NY. Organization (NPI-2).
NPI number1316618192
StatusActive
Last updated in NPPESSep 13, 2024
Details
- NPI
- 1316618192
- Entity type
- Organization (NPI-2)
- Legal business name
- Eden Health Medical Of Ma PC
- Organization subpart
- No
- Enumeration date
- Sep 22, 2021
- Certification date
- Sep 13, 2024
- Last updated
- Sep 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 101Y00000X | Counselor | – | – | |
| 225100000X | Physical Therapist | – | – |
Practice location
77 Goodell St Ste 510Buffalo, NY 14203-1258
Phone 917-261-4414
Mailing address
77 Goodell St Ste 510Buffalo, NY 14203-1258
Phone 917-261-4414
Authorized official
Kyon Hood
President
9172614414
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