BLT MEDICAL GROUP, LLP (NPI# 1386671816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386671816 |
| Entity Type | Organization |
| Organization Name | BLT MEDICAL GROUP, LLP |
| Practice Address |
1026 Union Rd West Seneca NY 14224-3445 |
| Mailing Address |
3719 Union Rd Suite 218 Cheektowaga NY 14225-4249 |
| Practice Telephone | 7167121030 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2017-01-26 |
| Authorized Official Name | LEROY W MCCUNE (PRESIDENT) |
| Authorized Official Telephone | 7166510911 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02782070 | 05 |
| Street Address |
1026 UNION RD |
| City | WEST SENECA |
| State | NY |
| Zip Code | 14224-3445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154327583 | Corry Lea Wierzbowski | Physician Assistant | 1026 Union Rd, West Seneca, NY 14224-3445 | 2005-06-21 |
| 1881170686 | Nicole Anna Fore | Physician Assistant | 1026 Union Rd, West Seneca, NY 14224 | 2018-07-15 |
| 1710493135 | Sarah Kathleen Mcgowan | Physician Assistant | 1026 Union Rd, West Seneca, NY 14224-3445 | 2017-12-21 |
| 1851815864 | Megan Christine Morano | Physician Assistant | 1026 Union Rd, West Seneca, NY 14224-3445 | 2017-08-01 |
| 1265989776 | Eat Live Nutrition, Pllc | Dietitian, Registered | 1026 Union Rd, West Seneca, NY 14224-3445 | 2016-09-01 |
| 1609238021 | Courtney Claire Hurley | Physician Assistant | 1026 Union Rd, West Seneca, NY 14224-3445 | 2016-03-24 |
| 1760841845 | Natalie Chapman | Physician Assistant | 1026 Union Rd, West Seneca, NY 14224-3445 | 2016-02-17 |
| 1851772354 | Anh-thu Ho Nguyen | Family Medicine | 1026 Union Rd, West Seneca, NY 14224-3445 | 2015-06-11 |
| 1578941613 | Erica Redenbach | Family Medicine | 1026 Union Rd, West Seneca, NY 14224-3445 | 2015-05-08 |
| 1760874390 | Heather Leary | Nurse Practitioner | 1026 Union Rd, West Seneca, NY 14224-3445 | 2015-02-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528338 | Jaimee Coscia | Behavior Technician | Autism Learning Partners Buffalo, 905a Union Rd #213, West Seneca, NY 14224 | 2020-11-04 |
| 1437711413 | Sara Jean Bucci | Massage Therapist | 4214 Clinton Street, West Seneca, NY 14224 | 2019-07-01 |
| 1679036115 | Darcy Zappia | Behavior Technician | 950a Union Rd #108, West Seneca, NY 14224 | 2019-04-11 |
| 1750858981 | Joelle Susan Wagner | Student in an Organized Health Care Education/Training Program | 767 Main Street, West Seneca, NY 14224 | 2018-10-25 |
| 1629545900 | Victoria A Luongo | Physician Assistant | 189 Fieldcrest Ct., West Seneca, NY 14224 | 2018-10-25 |
| 1659873776 | Lianna Marie Carroll | Physician Assistant | 1026 Union Road, West Seneca, NY 14224 | 2018-03-05 |
| 1124535141 | Joshua Conrad | Registered Nurse | 1010 East and West Road, West Seneca, NY 14224 | 2017-12-30 |
| 1285156232 | Southtowns P.t., Pllc | Physical Therapist | 100 Union Rd., West Seneca, NY 14224 | 2017-07-12 |
| 1164944260 | Patricia Ann Fenzel | Massage Therapist | 1909 Union Road, West Senca, NY 14224 | 2017-07-10 |
| 1356877666 | Megan A Malachowski | Physical Therapy Assistant | 67 Cove Creek Run, Buffalo, NY 14224 | 2017-05-05 |
| Find all providers in zip 14224 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023495561 | Alisha Lall | Family Medicine | 725 Orchard Park Rd Ste A, West Seneca, NY 14224-3352 | 2015-05-05 |
| 1790816387 | Thomas E. Degrave, Do,llc | Family Medicine | 4040 Clinton St, West Seneca, NY 14224-1519 | 2007-03-08 |
| 1619934601 | Bijay P. Ghoorah | Family Medicine | 736 Union Rd, West Seneca, NY 14224-3423 | 2006-04-26 |
| 1093776445 | David J Novelli | Family Medicine | 256 Center Rd, West Seneca, NY 14224-1947 | 2006-03-28 |
| 1386604452 | Pramila Penta | Family Medicine | 120 Gardenville Pkwy W, West Seneca, NY 14224-1324 | 2006-03-24 |
| 1841283629 | Geemson Oo | Family Medicine | 3775 Seneca Street, West Seneca, NY 14224 | 2005-08-26 |
| 1134591019 | David S. Clifford, Md | Family Medicine | 256 Center Rd, West Seneca, NY 14224-1947 | 2015-10-30 |
| 1851772354 | Anh-thu Ho Nguyen | Family Medicine | 1026 Union Rd, West Seneca, NY 14224-3445 | 2015-06-11 |
| 1578941613 | Erica Redenbach | Family Medicine | 1026 Union Rd, West Seneca, NY 14224-3445 | 2015-05-08 |
| 1861837361 | Brandon James Brownell | Family Medicine | 1026 Union Rd, West Seneca, NY 14224-3445 | 2013-05-09 |
| Find all providers in WEST SENECA | ||||
| City | WEST SENECA |
| Zip Code | 14224 |
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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.