Provider Demographics
NPI:1750575981
Name:BUFFALO PODIATRY GROUP
Entity type:Organization
Organization Name:BUFFALO PODIATRY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:N
Authorized Official - Last Name:TURSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:716-834-6555
Mailing Address - Street 1:2 RAVENSWOOD TER
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1126
Mailing Address - Country:US
Mailing Address - Phone:716-834-6555
Mailing Address - Fax:775-418-5011
Practice Address - Street 1:2 RAVENSWOOD TER
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14225-1126
Practice Address - Country:US
Practice Address - Phone:716-834-6555
Practice Address - Fax:775-418-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003494-1213E00000X
NYN003690-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005005111OtherB.C. & B.S. OF W.N.Y.
NY00843316Medicaid
NY00786865Medicaid
NY480026314OtherMEDICARE RAILROAD
NY0578510001OtherMEDICARE DME
NY005000871OtherB.C. & B.S. OF W.N.Y.
NY005050616OtherB.C. & B.S. OF W.N.Y.
NY480026315OtherMEDICARE RAILROAD
NY00843316Medicaid
NYA50615Medicare PIN
NY005000871OtherB.C. & B.S. OF W.N.Y.
NY0578510001OtherMEDICARE DME
NYT78273Medicare UPIN