Basic Information
| Provider Information | |||||||||
| NPI: | 1679844799 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EXIGENCE MEDICAL OF JAMESTOWN PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 JOHN JAMES AUDUBON PKWY | ||||||||
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| City: | AMHERST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142281143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7162044500 | ||||||||
| FaxNumber: | 7162044501 | ||||||||
| Practice Location | |||||||||
| Address1: | 207 FOOTE AVE | ||||||||
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| City: | JAMESTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147017077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166648422 | ||||||||
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| ProviderEnumerationDate: | 01/20/2012 | ||||||||
| LastUpdateDate: | 01/20/2012 | ||||||||
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| AuthorizedOfficialLastName: | DANIEL | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7162044500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.