| Forest Medical Group, Pllc | |
|
1360 N Forest Rd Suite 3 Williamsville NY 14221-1200 | |
| (716) 689-4800 | |
| (716) 689-4816 |
| Full Name | Forest Medical Group, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1360 N Forest Rd, Williamsville, New York |
| Authorized Official Name and Position | Richard F Divencenzo (PHYSICIAN , OWNER) |
| Authorized Official Contact | 7166894800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forest Medical Group, Pllc 1360 N Forest Rd Suite 3 Williamsville NY 14221-1200 Ph: (716) 689-4800 | Forest Medical Group, Pllc 1360 N Forest Rd Suite 3 Williamsville NY 14221-1200 Ph: (716) 689-4800 |
| NPI Number | 1215975289 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 11/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215975289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 188929-1 (New York) | Primary |
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