Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 289764 | NY |
NPI | 1003222092 |
---|---|
Provider Name | Dr. Robinder Bahniwal |
First Address | Buffalo, NY 14215 |
Second Address | Buffalo, NY 14215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2014 |
Last Update Date | 12/09/2017 |