Penque, Michelle Dolores

Penque, Michelle Dolores is an individual health care provider with primary practice located at 1001 Main St Fl 4 , Buffalo NY 14203-1009. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, which is considered as her primary health care specialty. Penque, Michelle Dolores can be contacted via phone (716) 323-0260.

Contact Information

Primary practice address
1001 Main St Fl 4 Buffalo NY 14203-1009
Phone: (716) 323-0260
Fax: (716) 323-0294
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 200803 New York

Profile Details

NPI number 1174571152
LBN Legal business name Penque, Michelle Dolores
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jan 20th, 2021 - about 3 years ago

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 1174571152 NPPES
Pennsylvania MEDICAID 0018522750001
Pennsylvania Other 040426001461
Pennsylvania Other 000524862001
Pennsylvania Other 3990839
Pennsylvania Other 00010310201
Pennsylvania MEDICAID 01776672

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