Provider Demographics
NPI:1174794010
Name:JOHN M BUDZINSKI, M.D.
Entity type:Organization
Organization Name:JOHN M BUDZINSKI, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARION
Authorized Official - Last Name:BUDZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-834-9472
Mailing Address - Street 1:85 WEHRLE DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1061
Mailing Address - Country:US
Mailing Address - Phone:716-834-9472
Mailing Address - Fax:716-834-7061
Practice Address - Street 1:85 WEHRLE DR
Practice Address - Street 2:SUITE 6
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-1061
Practice Address - Country:US
Practice Address - Phone:716-834-9472
Practice Address - Fax:716-834-7061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0934991207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00668364Medicaid
NY022101Medicare PIN
NY00668364Medicaid
NY022103Medicare PIN