Stanley Loyola Bukowski – Internal Medicine Physician

Key facts

NPI: 1922212596
Entity type: Individual (NPI type 1)
Primary specialty: Internal Medicine Physician 207R00000X
License: 163024 (NY)
Practice address: Wende Correctional Facility
3040 Wende Road
Alden, NY 14004-1187
Phone: (716) 937-4000
Fax: (716) 937-4244
NPI assigned: May 10, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Geriatric Associates, LLP Geriatric Medicine (Internal Medicine) Physician · Williamsville, NY · NPI 1750348306

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
163024	NY	MD	Internal Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
Geriatric Associates, LLP		Past since Jul 25, 2019	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician	207R00000X	163024	NY	Yes

Addresses

Primary practice location

Wende Correctional Facility
3040 Wende Road
Alden, NY 14004-1187

Mailing address

Wende Correctional Facility
3040 Wende Road
Alden, NY 14004-1187
Phone (716) 937-4000

Other providers in Alden, NY

All providers in Alden, NY · Internal Medicine Physician in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.