Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | C11365-6B | NY |
NPI | 1336284926 |
---|---|
Provider Name | Dr. John Matthew Bialecki |
First Address | Amherst, NY 14226-1900 |
Second Address | Amherst, NY 14226-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 25/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8814346 | INDEPENDENT HEALTH (01) | NY |
C11365-6B | WORKERS' COMPENSATION (01) | NY |
IA1146 | (02) | NY |