Bevilacqua, Thomas

Bevilacqua, Thomas is an individual health care provider with primary practice located at 111 N Maplemere Rd Ste 120 , Williamsville NY 14221-3178. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Bevilacqua, Thomas can be contacted via phone (716) 836-4646.

Contact Information

Primary practice address
111 N Maplemere Rd Ste 120 Williamsville NY 14221-3178
Phone: (716) 836-4646
Fax: (716) 836-4696
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 125.060174 Illinois
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 288107 New York

Profile Details

NPI number 1093094005
LBN Legal business name Bevilacqua, Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2011
Last updated Aug 18th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093094005 NPPES
New York MEDICAID 04873929

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