LOUBERT S SUDDABY MD PC (NPI# 1750412136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750412136 |
| Entity Type | Organization |
| Organization Name | LOUBERT S SUDDABY MD PC |
| Practice Address |
3775 Southwestern Blvd Suite A Orchard Park NY 14127-2159 |
| Practice Telephone | 7166671980 |
| Practice Fax Number | 7166671982 |
| Mailing Telephone | 7166671980 |
| Mailing Fax Number | 7166671982 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. LOUBERT S SUDDABY (OWNER) |
| Authorized Official Telephone | 7166671980 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 193722 | NY | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710164066 | Loubert S Suddaby Md PC | Neurological Surgery | 3775 Southwestern Blvd, Suite A, Orchard Park, NY 14127-2159 | 2008-01-29 |
| Street Address |
3775 SOUTHWESTERN BLVD SUITE A |
| City | ORCHARD PARK |
| State | NY |
| Zip Code | 14127-2159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447243522 | Diana Viola Medina | Nurse Practitioner | 3775 Southwestern Blvd, Ste A, Orchard Park, NY 14127 | 2005-08-24 |
| 1013479070 | Sara Ann Fagyas | Nurse Practitioner | 3775 Southwestern Blvd, Orchard Park, NY 14127-2159 | 2019-04-01 |
| 1487882403 | Crystal Marie Ammerman | Physician Assistant | 3775 Southwestern Blvd, Suite A, Orchard Park, NY 14127-2159 | 2009-06-29 |
| 1144461138 | Jessica Anne Dorsey | Massage Therapist | 3775 Southwestern Blvd, Suite A, Orchard Park, NY 14127-2159 | 2009-03-20 |
| 1710164066 | Loubert S Suddaby Md PC | Neurological Surgery | 3775 Southwestern Blvd, Suite A, Orchard Park, NY 14127-2159 | 2008-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902330 | Ellory Marie Roberts | Physical Therapist | 3065 Southwestern Blvd Ste. 108, Orchard Park Progressive Physical Therapy At Parkland P, Orchard Park, NY 14127 | 2020-11-03 |
| 1821649377 | Jeannine Ann Haak | Occupational Therapy Assistant | 6455 West Quaker Street, Orchard Park, NY 14127 | 2019-09-26 |
| 1578038147 | Cody Adam Barber | Counselor | 3176 Abbot Rd, Building A, Suite 500, Orchard Park, NY 14127 | 2018-10-09 |
| 1922522259 | Mikaela Rose Ditonto | Emergency Medical Technician, Basic | 7 Woodbine Ct., Orchard Park, NY 14127 | 2017-07-28 |
| 1770007098 | Mary C Daley | Psychologist | 196 Stonehenge Dr., Orchard Park, NY 14127 | 2017-07-28 |
| 1346762960 | Michael James Robb | Counselor | 3176 Abbott Rd., Bldg A. Suite 500, Orchard Park, NY 14127 | 2017-07-14 |
| 1740733575 | Nr Physician Group, Pllc | Radiology | 3910 N Buffalo St, Orchard Park, NY 14127 | 2016-07-28 |
| 1376096057 | Joshua E Weeks | Physician Assistant | 3671 Southwestern Blvd St 101, Suite 101, Orchard Park, NY 14127 | 2016-07-28 |
| 1922400746 | Anton Alisankus | Counselor | 272 Thorn Ave, Orchard Park, NY 14127 | 2014-09-24 |
| 1912324393 | Luke Lennox | Dermatology | 3900 N Buffalost, Williamsville, NY 14127 | 2014-03-24 |
| Find all providers in zip 14127 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619440757 | Lisa M Tomasik | Specialist | 40 Centre Dr Ste 1, Orchard Park, NY 14127-4100 | 2019-01-10 |
| 1518368430 | Erin Lafferty | Specialist | 46 Knob Hill Rd, Orchard Park, NY 14127-3931 | 2014-09-10 |
| 1285975540 | Buffalo Gastroenterology Associates, LLP | Specialist | 260 Red Tail Ln, Orchard Park, NY 14127-1562 | 2013-03-12 |
| 1306108188 | Tracy Connolly | Specialist | 6167 West Quaker Street, Therapeutic Link for Children, Orchard Park, NY 14127 | 2012-06-08 |
| 1265793335 | Michelle Kaczmarek | Specialist | 3815 Teachers Ln, 12, Orchard Park, NY 14127-2141 | 2012-06-05 |
| 1417218686 | Bernadette Marie Boland | Specialist | 6167 West Quaker St, Therapeutic Link for Children, Orchard Park, NY 14127 | 2012-06-05 |
| 1215115662 | Wny Breast Med and Surg Care,pc | Specialist | 55 Southwick Dr, Orchard Park, NY 14127-1650 | 2008-02-07 |
| 1225104128 | Lori C Petersen | Specialist | 6645 Milestrip Rd, Orchard Park, NY 14127-1609 | 2006-11-24 |
| 1760564843 | Ronald J Eckert | Specialist | 260 Red Tail, Orchard Park, NY 14127-1562 | 2006-10-19 |
| 1811079296 | Buffalo Gastroenterology Associates, LLP | Specialist | 260 Redtail Road, Orchard Park, NY 14127-1562 | 2006-10-19 |
| Find all providers in ORCHARD PARK | ||||
| City | ORCHARD PARK |
| Zip Code | 14127 |
Please comment or provide details below to improve the information on LOUBERT S SUDDABY MD PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.