Frederick Michael Elliott, MD, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

236287 Issued in NY

Legal business name

FREDERICK MICHAEL ELLIOTT, MD, PLLC

Practice address

897 Delaware Ave Ste 205
Buffalo, NY 14209-2087

Phone

(716) 768-2006

Fax

(716) 768-2007

NPI assigned

Jan 26, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Frederick Michael Elliott, MD

Title

Physician and Owner

Phone

(716) 768-2006

Specialties & licenses 1

Addresses

Other names 1

• Elmwood Village Primary Care Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359158400000",
    "number": "1336487396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 DELAWARE AVE STE 205",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092087",
            "telephone_number": "716-768-2006",
            "fax_number": "716-768-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 DELAWARE AVE STE 205",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092087",
            "telephone_number": "716-768-2006",
            "fax_number": "716-768-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK MICHAEL ELLIOTT, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-26",
        "last_updated": "2013-01-26",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN AND OWNER",
        "authorized_official_telephone_number": "716-768-2006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "236287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmwood Village Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyisha Frazier, BA
• Francisco Lorenzo Frazon Carbonar, M.D.
• Leann Frears
• Michele Frech, DO
• Glenn H Fredenburg
• Carla Anne Frederick, M.D.
• Peter Jonathan Frederick, MD
• Raeanne Fredericks
• Virginia Fredo
• Lorne Freedman

• Clinic/Center in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.