Basic Information
| Provider Information | |||||||||
| NPI: | 1376964973 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAKHRIBAH | ||||||||
| FirstName: | HATOON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ELM & CARLTON STREETS | ||||||||
| Address2: | ROSWELL PARK CANCER INSTITUTE | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168454101 | ||||||||
| FaxNumber: | 7168453423 | ||||||||
| Practice Location | |||||||||
| Address1: | ELM & CARLTON STREETS | ||||||||
| Address2: | ROSWELL PARK CANCER INSTITUTE | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168454101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2013 | ||||||||
| LastUpdateDate: | 12/27/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | P90-532 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.