Provider Demographics
NPI:1649357096
Name:DELAWARE SURGICAL GROUP PC
Entity type:Organization
Organization Name:DELAWARE SURGICAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:TIRANNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-636-9004
Mailing Address - Street 1:1150 YOUNGS RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8024
Mailing Address - Country:US
Mailing Address - Phone:716-636-9004
Mailing Address - Fax:716-636-0132
Practice Address - Street 1:1150 YOUNGS RD STE 202
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221-8024
Practice Address - Country:US
Practice Address - Phone:716-636-9004
Practice Address - Fax:716-636-0132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty