DR. MICHELLE DOLORES PENQUE (NPI# 1174571152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174571152 |
| Entity Type | Individual |
| Full Name | DR. MICHELLE DOLORES PENQUE |
| Credential | MD |
| Practice Address |
219 Bryant Street Buffalo NY 14222-2006 |
| Mailing Address |
4511 Harlem Road Suite 202 Amherst NY 14226-3822 |
| Practice Telephone | 7168787109 |
| Mailing Telephone | 7168396720 |
| Mailing Fax Number | 7168396740 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2009-12-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
200803 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01776672 | 05 | |
| FIDELIS | 040426001461 | 01 | |
| BC/BS | 000524862001 | 01 | |
| UNIVERA | 00010310201 | 01 | |
| PA | 0018522750001 | 05 | |
| IHA | 3990839 | 01 |
| Street Address |
219 BRYANT STREET |
| City | BUFFALO |
| State | NY |
| Zip Code | 14222-2006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114915287 | Lynne Marie Fries | Physician Assistant | 219 Bryant Street, Buffalo, NY 14222-2006 | 2005-10-12 |
| 1730619768 | Andrea Fatima D'mello | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Buffalo, NY 14222 | 2017-06-13 |
| 1285169953 | Jackelyn Lau | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Buffalo, NY 14222 | 2017-05-01 |
| 1114450335 | Zaheer Cheema | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Women and Children Hospital, Buffalo, NY 14222 | 2017-04-05 |
| 1053767780 | Traci Punturiero | Dietitian, Registered | 219 Bryant Street, Buffalo, NY 14222-2006 | 2016-05-12 |
| 1265888523 | Viveka Clare De Guerra | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Women & Children's Hospital of Buffalo, Buffalo, NY 14222 | 2016-05-05 |
| 1225415714 | Rim Elchaki | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Women & Children's Hospital of Buffalo, Buffalo, NY 14222 | 2015-05-04 |
| 1114312840 | Mallory Scogin | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Dept. of Obgyn, University At Buffalo, Buffalo, NY 14222 | 2015-03-31 |
| 1518300342 | Rabheh Abdul Aziz | Pediatrics | 219 Bryant Street, Buffalo, NY 14222-2006 | 2013-04-11 |
| 1992019558 | Natasha Gill | Student in an Organized Health Care Education/Training Program | 219 Bryant Street, Women & Children's Hospital of Buffalo, Buffalo, NY 14222 | 2010-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407414360 | Brittany Marie Dorsey | Registered Nurse | 770 W. Ferry St, Apt 25b, Buffalo, NY 14222 | 2019-06-04 |
| 1215495494 | Tina Colaizzo-anas | Dietitian, Registered | 214 Caudell Hall, 1300 Elmwood Avenue, Buffalo, NY 14222 | 2019-03-07 |
| 1558831560 | Nichole Virag | Doula | 195 Lexington Ave, E, Buffalo, NY 14222 | 2018-12-03 |
| 1487120234 | Lakieta L Smith | Massage Therapist | 820 Elmwood Ave, 5, Buffalo, NY 14222 | 2018-10-19 |
| 1235524646 | Ann Caughill | Registered Nurse | 257 Elmwood Ave., Room 303, Buffalo, NY 14222 | 2015-04-02 |
| 1255608535 | Vinay Sharma | Pediatrics | 239 Bryant Street, Division of Neonatology, Buffalo, NY 14222 | 2011-11-30 |
| 1558644757 | John Arthur Gillespie | Internal Medicine | 190 Bryant St., Buffalo, NY 14222 | 2011-09-23 |
| 1861773384 | Pamela Mary Sheehan-schreck | Nurse Practitioner | 239 Bryant St., 2nd Floor, Buffalo, NY 14222 | 2011-08-30 |
| 1295025286 | Jeanie Bowen Hayes | Specialist/Technologist | 90 Highland Avenue, Buffalo, NY 14222 | 2011-04-12 |
| 1649404260 | Colleen Ann Nugent | Pediatrics | 239 Bryant Str, Women and Children's Hospital of Buffalo, Buffalo, NY 14222 | 2009-05-11 |
| Find all providers in zip 14222 | ||||
| Taxonomy Code | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235399650 | Saikat Pal | Pediatrics | 219 Bryant St, Buffalo, NY 14222-2006 | 2008-06-10 |
| 1013192053 | Mary Ellen Emborsky | Pediatrics | 219 Bryant Street, Buffalo, NY 14222-2006 | 2008-01-09 |
| 1205892171 | John Marshall Tyo | Pediatrics | 219 Bryant Street, Buffalo, NY 14222-2006 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720496607 | Anthony Sheung Lai Yuen | Pediatrics | 525 E 68th St # 179, New York, NY 10065-4870 | 2014-07-24 |
| 1962817296 | Marina Rubin | Pediatrics | 475 Seaview Ave Dept Att, Staten Island, NY 10305-3436 | 2014-06-25 |
| 1487065462 | Munaza Batool Rizvi | Pediatrics | 450 Clarkson Avenue Box 59, Suny Downstate Medical Centre, Brooklyn, NY 11203 | 2014-05-13 |
| 1770844334 | Mark Oliver Tessaro | Pediatrics | 206 Front St, Apt 6b, Brooklyn, NY 11201-1214 | 2012-05-30 |
| 1548528482 | Dana Suozzo | Pediatrics | 2719 44th Dr Apt 16e, Long Island City, NY 11101-3052 | 2012-04-29 |
| 1629390315 | Inna Elikashvili | Pediatrics | 462 1st Ave Ste A345, New York, NY 10016-9196 | 2010-02-22 |
| 1164752788 | Monica Shekher-kapoor | Pediatrics | 36 North Dr, Great Neck, NY 11021-1332 | 2010-01-04 |
| 1073741377 | Selin Tuysuzoglu Sagalowsky | Pediatrics | 3959 Broadway # Chn-1116, New York, NY 10032-1559 | 2009-06-24 |
| 1053546242 | Heather Elizabeth Giambo | Pediatrics | 16th St and First Ave, Emergency Medicine, New York, NY 10009 | 2009-05-18 |
| 1184864738 | Anita K Pillai | Pediatrics | 220 North St, New Hyde Park, NY 11040-2332 | 2009-02-23 |
| Find all providers with the same taxonomy | ||||
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| 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.