Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 179621 | NY |
NPI | 1740244797 |
---|---|
Provider Name | Dr. Wayne Richard Waz |
First Address | Buffalo, NY 14203-1009 |
Second Address | Buffalo, NY 14203-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 19/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010186301 | UNIVERA HEALTHCARE (01) | |
000528205001 | BCBS OF WNY (01) | |
0014731570001 | (05) | PA |
0014731570001 | PENNSYLVANIA MEDICAID (01) | PA |
01291905 | (05) | NY |
040426001500 | FIDELISCARE NY (01) | |
4808929 | INDEPENDENT HEALTH ASSOC. (01) | |
F83856 | (02) |