Four Seasons Medical of Wny PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

195126 Issued in NY

Legal business name

FOUR SEASONS MEDICAL OF WNY PC

Practice address

2625 Harlem Rd
Ste 70
Cheektowaga, NY 14225-4031

Phone

(716) 462-5552

Fax

(716) 424-0790

NPI assigned

Dec 14, 2016

Organization subpart

Yes

Parent organization

FOUR SEASONS MEDICAL OF WNY PCAs reported in NPPES

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

Authorized official

Name

Mrs. Mary Ann Dirienzo, LPN

Title

Credentialing Specialist

Phone

(716) 984-2090

Specialties & licenses 1

Addresses

Part of

Four Seasons Medical of Wny PC

Locations

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1427592195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 HARLEM RD",
            "address_2": "STE 70",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254031",
            "telephone_number": "716-462-5552",
            "fax_number": "716-424-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 HARLEM RD",
            "address_2": "STE 70",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254031",
            "telephone_number": "716-462-5552",
            "fax_number": "716-424-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS MEDICAL OF WNY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOUR SEASONS MEDICAL OF WNY PC",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "DIRIENZO",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "716-984-2090",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "195126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Ann Flynn
• Natalie Foglia
• Katharine Folaron, LPN
• Christy Ford, MS
• Dominique Ford, LPN
• Ellen Fox, RN
• Valerie Fox
• Crystal M Foy, MSED.
• Rachelle Fralick
• Francis W. Lesinski DDS

• Health Service Clinic/Center in Cheektowaga, NY
• Providers in Cheektowaga, NY by specialty
• Health Service Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.