Provider Demographics
NPI:1346328713
Name:NEIDERMAN, GEORGE GEOFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:GEOFFREY
Last Name:NEIDERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:462 GRIDER ST STE 1152
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3021
Mailing Address - Country:US
Mailing Address - Phone:716-898-4803
Mailing Address - Fax:716-898-6266
Practice Address - Street 1:462 GRIDER ST STE 1152
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-4803
Practice Address - Fax:716-898-6266
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184789207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY100144295602OtherAMERICHOICE
NYP867408OtherOXFORD
NY000917442OtherAMERICAN POSTAL WORKERS UNION
NY02714810OtherMAGNACARE
NYP00603271OtherRAILROAD MEDICARE PTAN
NY0812634OtherAETNA
NYPR78617270001OtherCIGNA
NYP00000206898OtherGHI
NY01562101Medicaid
NY01562101Medicaid
NYP00603271OtherRAILROAD MEDICARE PTAN
NY01562101Medicaid