Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Apr 13, 2006
License(s)
159055-1 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3045 SOUTHWESTERN BLVD STE 104 | Orchard Park, NY 14127-1209 | 716-675-7000 |
| MAILING | 3045 SOUTHWESTERN BLVD STE 104 | Orchard Park, NY 14127-1209 | 716-675-7000 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.