Active NPI
Eastern Niagara OB/GYN, PC
- Obstetrics & Gynecology Physician
- Lockport, NY
National Provider Identifier
1669422697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- EASTERN NIAGARA OB/GYN, PC
- Practice address
- 175 Walnut St.
Suite 7
Lockport, NY 14094-3775 - Phone
- (716) 433-1941
- Fax
- (716) 439-1233
- NPI assigned
- May 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Roger G Jammal, MD
- Title
- President
- Phone
- (716) 433-1941
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary |
Addresses
Primary practice location
175 Walnut St.
Suite 7
Lockport, NY 14094-3775
Mailing address
175 Walnut St.
Suite 7
Lockport, NY 14094-3775
Phone (716) 433-1941
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00929593 | Medicaid | NY |
National Provider Directory
National Provider DirectoryLocations
175 Walnut St
Lockport, NY 14094
Phone (716) 251-7007
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Lockport, NY
- NPI 1083670681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1437177600000",
"number": "1669422697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 WALNUT ST.",
"address_2": "SUITE 7",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140943775",
"telephone_number": "716-433-1941",
"fax_number": "716-439-1233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 WALNUT ST.",
"address_2": "SUITE 7",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140943775",
"telephone_number": "716-433-1941",
"fax_number": "716-439-1233"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EASTERN NIAGARA OB/GYN, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-11",
"last_updated": "2015-07-18",
"status": "A",
"authorized_official_last_name": "JAMMAL",
"authorized_official_first_name": "ROGER",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "716-433-1941",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00929593",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lockport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.