Provider Demographics
NPI:1780246777
Name:WNY MEDICAL PC - CARE MANAGEMENT
Entity type:Organization
Organization Name:WNY MEDICAL PC - CARE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RIFFAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SADIQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-923-4380
Mailing Address - Street 1:5792 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5702
Mailing Address - Country:US
Mailing Address - Phone:716-923-4380
Mailing Address - Fax:
Practice Address - Street 1:4979 HARLEM RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2547
Practice Address - Country:US
Practice Address - Phone:716-923-4380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WNY MEDICAL, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-01
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty