Queen City Internal Medicine of W.N.Y.P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

QUEEN CITY INTERNAL MEDICINE OF W.N.Y.P.C.

Practice address

2950 Elmwood Ave
Kenmore, NY 14217-1304

Phone

(716) 447-6100

NPI assigned

Sep 27, 2007

Organization subpart

No

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

Authorized official

Name

Hanaw A Adham, M.D,

Title

Owner

Phone

(716) 625-8876

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1508053208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 ARCADIAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283736",
            "telephone_number": "716-625-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171304",
            "telephone_number": "716-447-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEEN CITY INTERNAL MEDICINE OF W.N.Y.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "ADHAM",
        "authorized_official_first_name": "HANAW",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-625-8876",
        "authorized_official_credential": "M.D,"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02960474",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Profeta, PT
• Dominique Latoya Prophet, COTA
• Kaylee Jo Przybysz
• David Anthony Przynosch, AUD
• Purely Connected, LLC
• Brenda Queeno, PHARM.D
• Laura Quinn, MS, OTR/L
• Annie Rabe
• Jamie Rackl
• Kim M Raczkowski

• Internal Medicine Physician in Kenmore, NY
• Providers in Kenmore, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.