Organization Active NPI

George a Haddad MD PC

  • Legal Medicine
  • Kenmore, NY
National Provider Identifier
1982971727
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
189835-1 Issued in NY
Legal business name
GEORGE A HADDAD MD PC
Practice address
3800 Delaware Ave
Suite 100
Kenmore, NY 14217-1094
Phone
(716) 876-3737
Fax
(716) 447-0627
NPI assigned
Nov 22, 2011
Last updated
Nov 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Authorized official

Name
Dr. George A Haddad, MDNPI 1154488351
Title
Physician
Phone
(716) 876-3737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 189835-1 NY Primary

Addresses

Primary practice location

3800 Delaware Ave
Suite 100
Kenmore, NY 14217-1094

Mailing address

3800 Delaware Ave
Suite 100
Kenmore, NY 14217-1094
Phone (716) 876-3737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111209000718 NY Part B Supplier - Clinic/Group Practice 3476728007 Receives reassigned benefits from 1 practitioner
Practice locations: Kenmore, NY

National Provider Directory

National Provider Directory

Locations

3800 Delaware Ave
Ste 100
Kenmore, NY 14217
Phone (716) 876-3737

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321920000000",
    "number": "1982971727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 DELAWARE AVE",
            "address_2": "SUITE 100",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171094",
            "telephone_number": "716-876-3737",
            "fax_number": "716-447-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 DELAWARE AVE",
            "address_2": "SUITE 100",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171094",
            "telephone_number": "716-876-3737",
            "fax_number": "716-447-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE A HADDAD MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-22",
        "last_updated": "2011-11-22",
        "status": "A",
        "authorized_official_last_name": "HADDAD",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "716-876-3737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "189835-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.