Ralph Wynn, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

134158 Issued in NY

Practice address

1540 Maple Rd
Williamsville, NY 14221-3647

Phone

(716) 878-7662

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1639148570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD",
            "address_2": "SUITE 208",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "716-692-3302",
            "fax_number": "716-692-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213647",
            "telephone_number": "716-878-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "RALPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "134158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000507560001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00639170",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010191701",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426000743",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "3605818",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Beth Persons Wrobleski, RPH
• Michael Joseph Wrona, D.C.
• Tiger Wu, M.D.
• Jonathan David Wurstner, D.C.
• Michelle Wynn
• Amy M Wynne, RN
• Xesus House of Prayer, Inc.
• Xesus Therapy Services
• Annie Han Xu, OT, LPN
• Molly Yager, LPN

• Neonatal-Perinatal Medicine Physician in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Neonatal-Perinatal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.