Provider Demographics
NPI:1144299892
Name:TWIN CITY PHYSICIANS GROUP P.C.
Entity type:Organization
Organization Name:TWIN CITY PHYSICIANS GROUP P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKATS III
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:716-447-8868
Mailing Address - Street 1:50 ALCONA AVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-2201
Mailing Address - Country:US
Mailing Address - Phone:716-834-1191
Mailing Address - Fax:716-834-1382
Practice Address - Street 1:445 TREMONT ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-6150
Practice Address - Country:US
Practice Address - Phone:716-694-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY111498900OtherDEPARTMENT OF LABOR
NY399009OtherINDEPENDENT HEALTH
NY00011179801OtherUNIVERA
NY000507856001OtherBLUE CROSS
NY00645405Medicaid
NY399009OtherINDEPENDENT HEALTH